Does laparoscopic IPAA lead to fewer postoperative complications than open IPAA in patients with UC

What is known

- The meta-analysis found no significant difference in mortality or postoperative complications, with laparoscopic IPAA carrying ~90 min longer operative time and better cosmesis as its main distinction. ¹ - In a 401-patient cohort, open IPAA had a lower incidence of VTE and fewer 30-day readmissions than both laparoscopic and robotic approaches, and pouch failure did not differ by technique. ²

What is unknown / caveats

- Cohort found open superior on VTE/readmission, contradicting the presumed minimally-invasive benefit and the general literature on VTE risk - Only 2 distinct sources retrieved; evidence is thin - The 2009 meta-analysis authors called for large high-quality trials; those trials are not represented here - The 2025 cohort is retrospective and pools laparoscopic with robotic when comparing to open, blurring a pure lap-vs-open contrast - The retrieved evidence does not establish a complication advantage for laparoscopic over open IPAA and in one cohort points the opposite direction.

## References

1. Ahmed Ali U, Keus F, Heikens JT, Bemelman WA, Berdah SV, Gooszen HG, van Laarhoven CJ. Open versus laparoscopic (assisted) ileo pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis. Cochrane Database Syst Rev. 2009;ePub only:CD006267. PMID: 19160273.

2. Violante T, Broccard SP, Novelli M, Stocchi L, Colibaseanu DT, DeLeon MF, Behm KT, Mishra N, Larson DW, Merchea A. Comparative analysis of robotic, laparoscopic, and open ileal pouch-anal anastomosis outcomes: retrospective cohort study. BJS Open. 2025;9:ePub only. PMID: 40742352.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._