Abstract Background Despite advances in biologics and small molecules, many patients with inflammatory bowel disease (IBD) still require colorectal surgery. Surgical timing and perioperative optimisation are increasingly coordinated within multidisciplinary IBD Teams. Minimally invasive approaches, including laparoscopic and robot-assisted techniques, are widely used, but real-world comparative data in IBD remain limited.Our aim was to compare perioperative outcomes between robot-assisted and laparoscopic colorectal surgery among IBD patients discussed in an IBD Team. Methods We prospectively analysed IBD patients undergoing laparoscopic or robot-assisted colorectal surgery. Baseline clinical and laboratory data and postoperative outcomes were collected. Continuous and categorical variables were compared using Mann–Whitney U and Fisher’s exact tests. Results Seventy-six patients underwent minimally invasive surgery: 62 laparoscopic and 14 robot-assisted. Four laparoscopic cases involved ulcerative colitis, whereas all robotic procedures were performed for Crohn’s disease. The robotic group had longer disease duration and slightly lower preoperative BMI (21.2 vs 22.53; p = 0.968). Preoperative albumin (41.0 vs 37.0 g/L; p = 0.579) and CRP showed no significant differences. Postoperative CRP declined similarly in both groups. Preconditioning was applied in 28% of laparoscopic and 21% of robotic cases; prior biologic exposure was common in both cohorts. Postoperative length of stay tended to be shorter after robotic surgery (5.5 vs 7 days; p = 0.128). Overall complications were comparable (p = 0.102). Reoperation was more frequent after robotic procedures (4/14 vs 2/62; p = 0.0079), while recurrence rates were low and similar. At follow-up, haemoglobin, iron and white blood cell count improved in both groups, accompanied by a rise in BMI, consistent with the recovery of nutritional and inflammatory status. Conclusion Robot-assisted colorectal surgery was used more often in patients with complex or long-standing Crohn’s disease. Despite these baseline differences, postoperative outcomes, including biochemical recovery, were broadly comparable to laparoscopy, with a trend toward shorter hospitalization after robotic procedures. The higher reoperation rate in the robotic cohort likely reflects more challenging case selection and limited sample size. Robot-assisted surgery appears promising for selected IBD patients, but larger prospective studies are needed to define its optimal indications and long-term benefits. Conflict of interest: Dr. Élthes, Zsuzsa: No conflict of interest Pályu, Eszter: No conflict of interest Lénárt, Ágnes: No conflict of interest Tóth, Dezső: No conflict of interest Kanyári, Zsolt: No conflict of interest Berényi, Ervin: No conflict of interest Tóth, Judit: No conflict of interest Papp, Maria: No conflict of interest Palatka, Károly: No conflict of interest
Élthes et al. (2026) studied this question.