title: Minimally invasive treatment of difficult bleeding lesions of the small bowel.
abstract: 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 mL. 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.
authors.affiliation: Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois, Chicago, IL, USA - mmasrur@uic.edu.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Masrur
authors.forename: Despoina
authors.initials: D
authors.lastname: Daskalaki
authors.forename: Andrea
authors.initials: A
authors.lastname: Vannucchi
authors.forename: Siddharth N
authors.initials: SN
authors.lastname: Vannemreddy
authors.forename: Luis F
authors.initials: LF
authors.lastname: Gonzalez-Ciccarelli
authors.forename: Ross
authors.initials: R
authors.lastname: Rbrown
authors.forename: C
authors.initials: C
authors.lastname: Pier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D058582:Double-Balloon Enteroscopy / Q000379:methods; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007082:Ileum / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery*; D007583:Jejunum / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000379:methods; D016896:Treatment Outcome