Minimally invasive treatment of difficult bleeding lesions of the small bowel.

BACKGROUND: Bleeding lesions of the small bowel are often difficult to identify due to the obscure symptomatology. Localizing these lesions requires specific techniques. The Double-balloon enteroscopy (DBE) could be used to precisely localize and mark lesions, so that a minimally invasive surgical treatment could be performed. METHODS: Twenty robot-assisted small bowel procedures are presented using a combination of DBE for localization and robotic resection. RESULTS: There were 10 jejunal resections and 10 ileal resections. Mean age was 58.7 years. Mean operative time was 153.4 minutes, mean blood loss of 46 ad,. No conversion-to-open and there were 4 post-operative complications. The 90-day mortality was nil and the median length of stay was 4.1 days. Final pathology was consistent with malignancy in 10 cases. CONCLUSIONS: The combination of double-balloon enteroscopy and robotic technology allows accurate identification and selective treatment of lesions that could be otherwise difficult to treat in a minimally invasive fashion.