Clinical outcomes of robotic and laparoscopic ileal pouch–anal anastomosis in ulcerative colitis: A retrospective cohort from two tertiary referral centers

Background: Robotic platforms may facilitate the technically demanding pelvic and multiquadrant components of ileal pouch-anal anastomosis (IPAA), but comparative evidence remains limited. Methods: We retrospectively compared 90-day outcomes after robotic (n = 36) and laparoscopic (n = 24) IPAA for ulcerative colitis performed by one surgical team at two tertiary referral centers between 2014 and 2025. The primary outcome was postoperative morbidity. Logistic regression adjusted for operative staging; an exploratory model additionally adjusted for age, sex, and body mass index. Results: Ninety-day morbidity occurred in 30.6% of robotic and 41.7% of laparoscopic patients (P = .377). Major morbidity, operative time, blood loss, length of stay, readmission, and reoperation did not differ significantly. The robotic approach was not associated with morbidity in the primary model (adjusted OR, 0.60; 95% CI, 0.20–1.80; P = .361). Conclusions: Robotic IPAA showed no evidence of increased short-term morbidity compared with laparoscopy in this single-team cohort.