AimThe Kono‐S anastomosis was introduced as a possible solution to the high surgical recurrence rates in Crohn's disease. However, this technique is known to be challenging, which is why it was originally performed in an extracorporeal setting. The aim of this case series was to assess safety, in terms of intra‐/postoperative complications, and feasibility, in terms of successful performance of anastomosis, of a robot‐assisted intracorporeal Kono‐S anastomosis.MethodThis is a prospective single‐centre consecutive case series. Patients were considered eligible if they were diagnosed with refractory Crohn's disease with significant bowel stenosis of the terminal ileum. All patients underwent robot‐assisted intracorporeal Kono‐S anastomosis. Perioperative care was provided according to the Enhanced Recovery After Surgery® protocol. Follow‐up for postoperative complications was 30 days.ResultsTwenty patients were included, of whom 11 (55%) were men. The median age was 30 years [interquartile range (IQR) 22–51 years] and the median BMI was 25 kg/m2 (IQR 19–28 kg/m2). Intracorporeal Kono‐S anastomosis was successfully performed in all cases. The median operating time was 155 min (IQR 144–176 min) and the median length of stay was 3 days (IQR 1–5 days). No conversions or 30‐day mortality were observed. One patient experienced anastomotic leakage, which was treated with radiologically guided drainage. A total of three patients experienced postoperative complications in the first 30 days.ConclusionPerformance of intracorporeal robot‐assisted Kono‐S anastomosis seems safe and feasible in this case series for Crohn's disease. Since this is a first case series, further research is required to confirm results in a larger population‐based cohort.

中文翻译：

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一种新的手术技术：克罗恩病的机器人体内 Kono-S 吻合术——关于短期结果的安全性和可行性病例系列

目的Kono-S 吻合术被引入作为克罗恩病高手术复发率的可能解决方案。然而，众所周知，这项技术具有挑战性，这就是为什么它最初是在体外环境中进行的。本病例系列的目的是评估机器人辅助的 Kono-S 体内吻合术在术中/术后并发症方面的安全性以及在成功执行吻合方面的可行性。方法这是一项前瞻性单中心连续手术案例系列。如果患者被诊断患有难治性克罗恩病且回肠末端显着狭窄，则被认为符合资格。所有患者均接受机器人辅助Kono-S体内吻合术。根据加速康复外科®方案提供围手术期护理。术后并发症随访 30 天。结果 纳入 20 名患者，其中 11 名（55%）为男性。中位年龄为 30 岁 [四分位距 (IQR) 22-51 岁]，中位 BMI 为 25 kg/m2（IQR 19–28 千克/米2）。所有病例均成功进行了体内Kono-S吻合术。中位手术时间为 155 分钟（IQR 144-176 分钟），中位住院时间为 3 天（IQR 1-5 天）。没有观察到转化或 30 天死亡率。一名患者出现吻合口瘘，并接受放射引导引流治疗。总共有 3 名患者在前 30 天内出现术后并发症。 结论 在本例克罗恩病病例系列中，进行体内机器人辅助 Kono-S 吻合术似乎是安全可行的。由于这是第一个病例系列，因此需要进一步研究以在更大的人群队列中确认结果。