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Comparative Study
. 2020 Jun;34(6):2495-2502.
doi: 10.1007/s00464-019-07055-8. Epub 2019 Aug 5.

Robot-assisted hiatal hernia repair demonstrates favorable short-term outcomes compared to laparoscopic hiatal hernia repair

Basem G Soliman  1 , Duc T Nguyen  2 , Edward Y Chan  1   3 , Ray K Chihara  1 , Leonora M Meisenbach  1 , Edward A Graviss  2 , Min P Kim  4   5
Affiliations
Comparative Study

Robot-assisted hiatal hernia repair demonstrates favorable short-term outcomes compared to laparoscopic hiatal hernia repair

Basem G Soliman et al. Surg Endosc. 2020 Jun.

Abstract

Background: We postulated that the use of robotics may improve outcomes in hiatal hernia repair.

Methods: We performed a retrospective analysis of a prospectively collected Society of Thoracic Surgery database at a single institution of patients who underwent elective hiatal hernia repair from 2012 to 2017 using either laparoscopy or the da Vinci Xi robot. We compared patient characteristics and outcomes and then performed univariate and multivariate logistic regression modeling to determine the factors associated with postoperative morbidity.

Results: There were 293 consecutive patients who underwent elective hiatal hernia repair using either a laparoscopic (n = 151) or a robotic (n = 142) technique. There were no significant differences in age, gender, BMI, smoking history, presence of comorbidity, or hiatal hernia type. Seventy percent of the cases were a repair of either type III or type IV hiatal hernia. There were significantly higher ASA III and IV (7.9% vs. 4.2%, P = 0.03), higher Toupet fundoplication (83.4% vs. 44.4%, P < 0.001), and lower redo-repair (7.3% vs. 20.4%, P = 0.001) in the laparoscopic group compared to the robotic group. The hospital length of stay was significantly shorter (1.3 ± 1.8 vs. 1.8 ± 1.5 days, P = 0.003) and there were significantly lower rates of complications (6.3 vs. 19.2%, P = 0.001) after robotic compared to laparoscopic hiatal hernia repair. There was no difference in readmission rate and mortality. Multiple logistic regression analysis showed that older age and laparoscopic technique were associated with higher complications after surgery.

Conclusion: The use of the Da Vinci Xi robot in our institution was associated with improved outcomes compared to laparoscopic hiatal hernia repair despite a higher incidence of re-operative cases in the robotic group. Thus, short-term outcomes of Da Vinci Xi robot-assisted hiatal hernia repair are not inferior to laparoscopic hiatal hernia repair. Further studies are needed to determine if Da Vinci Xi robot provides superior short-term and long-term outcome in treatment of symptomatic hiatal hernia.

Keywords: Da Vinci Xi; Laparoscopic hiatal hernia repair; Robotic hiatal hernia repair.

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References

    1. Peters JH (2013) SAGES guidelines for the management of hiatal hernia. Surg Endosc 27:4407–4408. https://doi.org/10.1007/s00464-013-3212-0 - DOI - PubMed
    1. Cuschieri A, Shimi S, Nathanson LK (1992) Laparoscopic reduction, crural repair, and fundoplication of large hiatal hernia. Am J Surg 163:425–430. https://doi.org/10.1016/0002-9610(92)90046-T - DOI - PubMed
    1. Broeders IAMJ (2014) Robotics: the next step? Best Pract Res Clin Gastroenterol 28:225–232. https://doi.org/10.1016/j.bpg.2013.12.001 - DOI - PubMed
    1. Matanes E, Lauterbach R, Boulus S, Amit A, Lowenstein L (2018) Robotic laparoendoscopic single-site surgery in gynecology: a systematic review. Eur J Obstet Gynecol Reprod Biol 231:1–7. https://doi.org/10.1016/j.ejogrb.2018.10.006 - DOI - PubMed
    1. Ramirez D, Maurice MJ, Kaouk JH (2016) Robotic single-port surgery: paving the way for the future. Urology 95:5–10. https://doi.org/10.1016/j.urology.2016.05.013 - DOI - PubMed

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