Robotic vs. laparoscopic redo ileocolonic resection for recurrent Crohn's disease.

Robotic surgery is increasingly utilized for primary ileocolic Crohn’s disease (CD), but its role in recurrent CD is less established. This study aimed to evaluate the feasibility and outcomes of robotic redo ileocolic resection (ICR). We retrospectively reviewed adult patients with recurrent CD who underwent either robotic (RR-ICR) or laparoscopic redo (LR-ICR) ICR at our institution between January 2020 and November 2024. Perioperative variables, conversion rate, short- and long-term postoperative outcomes were compared. Sixty-six patients were included: 24 (36.4%) underwent RR-ICR and 42 (63.6%) LR-ICR. RR-ICR was associated with a significantly lower conversion rate (4.2% vs. 23.8%, p = 0.046) and higher rate of intracorporeal anastomosis (70.8% vs. 7.1%, p < 0.001). Short-term outcomes, including morbidity (33.3% vs. 31%, p = 1), length of postoperative stay (3.6 ± 1.8 vs. 3.6 ± 2.2, days, p = 0.69), and 30-day readmission (both 16.7%, p = 1), were similar between groups. The cumulative endoscopic recurrence (ER)-free rates at 12 and 24 months were 72.1% and 51.4% in the RR-ICR group and 74.7% and 37.3% in the LR-ICR group, respectively, with no significant differences in time-to-event analysis for ER (p = 0.91) or clinical recurrence rates (p = 0.35) between the groups. On multivariable analysis, only male gender was independently associated with increased risk of ER (Hazard ratio (HR): 2.54, p = 0.028). Robotic redo ileocolic resection is a safe and feasible alternative which could offer some advantage when compared with laparoscopic surgery in patients with recurrent CD.