Laparoscopic Ileo-Colic Resection with Radiofrequency Device in Crohn Disease

Objective: Since the introduction of laparoscopic colorectal surgery, several studies have demonstrated the advantages of mini-invasive segmental colon resections in the treatment of benign diseases. Laparoscopic ileo-colic resection in complicated Crohn’s disease is often difficult. The presence of fistula, abscess, and inflammation could make the dissection challenging. The use of a radiofrequency vessel-sealing system device both in dissection and vessel ligation, as a unique instrument, seems to make the procedure easier with a low rate of conversion. The aim of this report is to show the feasibility and safety of laparoscopic ileo-colic resection with a radiofrequency device. Materials and Methods: Between January 2009 and December 2010 at our institution, 13 patients underwent to laparoscopic ileo-colic resection with a radiofrequency device for complicated Crohn’s disease. Results: The mean age was 42.3 years, and the preoperative endoscopy showed an ileocecal valve of distal ileum stenosis or fistula. Mean operative time was 166 minutes, and the estimated mean blood loss was 100cc. No conversions occurred. In all cases but one, the margins of resection were disease free. Two postoperative complications occurred: 1 anastomotic dehiscence and 1 intestinal perforation, both surgically treated. No mortalities occurred. The mean hospital stay was 8 days. Conclusions: The analysis of our data highlights that laparoscopic ileo-colic resection with a radiofrequency device is effective and feasible even if this procedure, because of its complexity and for the intrinsic characteristics of the disease, has to be reserved for well-trained laparoscopic surgeons and does not eliminate the risk of postoperative complications.