Laparoscopic Versus Open Ileocolic Resection

Open surgery was performed via vertical midline laparotomy with ileocolic mobilisation and subsequent anteposition of the mobilised bowel segment through laparotomy. The next steps are the same for both OG and LG. Laparoscopy was initially done by three-port access (one umbilical, one left epigastric and one in the left iliac fossa, all 5 mm) and subsequently single incision laparoscopic surgery with “self-made” port (Alexis^®, Applied Medical, Rancho Santa Margarita, CA and rubber glove) via vertical incision in umbilicus was performed. Laparoscopy started with assessment of the small and large bowel. The right colon, hepatic flexure and ileocecal region were mobilised laparoscopically with monopolar electrocautery, and the diseased segment was exteriorized through 2–3 cm extension of the umbilical trocar site. The mesentery was divided extracorporeally, the diseased segment was excised, and a primary ileocolic anastomosis was performed. After gaining sufficient experience with laparoscopy, a laparoscopic programme was launched in IBD surgery and since 2018, we have started surgery laparoscopically for all patients, and only in the event of an unfavourable intra-abdominal findings is there a conversion to open surgery.