Randomized clinical trial of standard laparoscopic versus robot-assisted laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease

Abstract

RNF yielded similar subjective and objective results to LNF in this study. Therefore no additive value of robotic systems for this procedure was detected up to 6 months after surgery.

Robotic Foregut Surgery: One Surgeon’s Experience with Nissen Fundoplication, Esophagomyotomy, and Hiatal Hernia Repair

“…The published literature reports a perioperative complication average of 7.3% (0 -24) for robotic Nissen fundoplication patients [4][5][6][7][8][9][10][11][12][13], 6.4% (3 -13) for esophagomyotomy patients [16][17][18][19], and 15% (0 -31) for hiatal hernia repair patients [19][20][21]. Our series had similar results with 7% of Nissen fundoplication patients, 15% of esophagomyotomy patients, and 11% of hiatal hernia repair patients experiencing perioperative complications.…”

“…The mean TCT in the robotic Nissen fundoplication literature ranges from 65 -207 minutes [4][5][6][7][8][9][10][11][12][13]. Our mean TCT was 173 minutes, which is within that range but on the higher end.…”

“…The first was a misshaped fundoplication requiring reoperation to correct the problem and the second was a gastric leak that occurred where a short gastric vessel was ligated through excessive periomental fat. Draaisma et al [10] looked at 25 cases and reported six perioperative complications (24%). These included liver capsule tears in 2 patients, minor bleeding in 2 patients, dysphagia post operatively due to the fundoplication being too tight requiring re-operation, and an incisional hernia 3 months post-operatively requiring repair.…”

“…The published literature reports a conversion rate average of 2.9% (0 -9) for Nissen fundoplication patients [4][5][6][7][8][9][10][11][12][13], 3.4% (0 -12.5) for esophagomyotomy patients [16,17,19], and 6.6% (0 -10.5) for hiatal hernia repair patients [19][20][21]. Of these, all of the Nissen fundoplication conversions were to laparoscopy, while all of the hiatal hernia conversions were to laparotomy.…”

“…(1 -7.2) days for robotic Nissen fundoplication patients [4][5][6][7][8][9][10][11][12][13], 2.4 (1.5 -4) days for esophagomyotomy patients [8,[14][15][16][17][18], and 5 days for hiatal hernia repair patients [19][20][21]. Our series had a shorter LOS for all groups with a mean LOS of 1.7 days for all three procedures combined, 1.7 days for the Nissen fundoplication group, 1.2 days for the esophagomyotomy group, and 2.3 days for the hiatal hernia repair group.…”