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

Soliman, Basem; Nguyen, Duc T.; Chan, Edward Y.; Chihara, Ray; Meisenbach, Leonora M.; Graviss, Edward A.; Kim, Min P.

doi:10.1007/s00464-019-07055-8

Cited by 38 publications

(33 citation statements)

References 20 publications

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“…Similar findings have been found in other complex operations performed using robotic surgery compared to open technique for gastric, pancreatic, colon, rectal, lung, prostate and uterine oncologic resections (1,(5)(6)(7). Comparing clinical outcomes between robotic techniques and conventional laparoscopic or thoracoscopic techniques is difficult methodologically; however, studies have emerged implicating improved clinical outcomes for operations where robotic techniques have matured (6)(7)(8).…”

supporting

confidence: 69%

Robotic surgery facilitates complex minimally invasive operations

2020

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supporting

confidence: 69%

Robotic surgery facilitates complex minimally invasive operations

2020

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“…Their study was limited to 30-day outcomes, so the longer-term results of the robotic approach remain unknown. 7 The study presented here represents the largest comparison between laparoscopic and robotic approaches to hiatal hernia repair to date. It also is the only study to report 1-year outcomes with mean follow-up of 23.7 and 15.1 months, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Though robotic hiatal hernia repair has been performed for the past 2 decades, the majority of the literature to date has been small case series with favorable outcomes. 6,7 More recently, the first large direct comparisons between the two approaches have been performed and shown improvements in 30-day complication and shorter length of stay (LOS) with robotic assistance. They have also found an increased portion of recurrent hiatal repairs being performed robotically, indicating the capability of and surgeons' preference for the robotic platform when performing a difficult dissection in a reoperative field.…”

Section: Introductionmentioning

confidence: 99%

“…They have also found an increased portion of recurrent hiatal repairs being performed robotically, indicating the capability of and surgeons' preference for the robotic platform when performing a difficult dissection in a reoperative field. 7 Even so, concerns over increased operative time and procedural costs have prevented widespread adoption of the robotic approach. Also, no long-term studies have yet evaluated the durability of the repair or symptom relief after robotic repair.…”

Section: Introductionmentioning

confidence: 99%

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Robotic Versus Laparoscopic Approach to Hiatal Hernia Repair: Results After 7 Years of Robotic Experience

O’Connor

Mallard

Desai

et al. 2020

The American Surgeon

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Introduction Robotic hiatal hernia repair offers potential advantages over traditional laparoscopy, most notably enhanced visualization, improved ergonomics, and articulating instruments. The clinical outcomes, however, have not been adequately evaluated. We report outcomes of laparoscopic and robotic hiatal hernia repairs. Methods A retrospective observational cohort study was performed of all hiatal hernia repairs performed from 2006 through 2019. Operative, demographic, and outcomes data were compared between laparoscopic and robotic groups. Discrete variables were analyzed with Chi-square of Fisher’s exact test. Continuous variables were analyzed with Student’s t test (mean) or Wilcoxon rank sum (medians). All analyses were performed using R statistical software. Results Laparoscopic repair was performed in 278 patients and robotic repair in 114. More recurrent hernias were repaired robotically (24.5% vs 12.9%, P = .08). Operative times were no different between groups (175 vs 179 minutes; P = .681). Robotic repair resulted in significantly shorter length of stay (LOS; 2.3 vs 3.3 days; P = .003). Rate of readmission was no different, and there were no differences in acute complications. For patients with at least 1 year of follow-up, recurrence rates were lower after robotic repair (13.3% vs 32.8%; P = .008); however, mean follow-up is significantly longer after laparoscopic repair (23.7 ± 28.4 vs 15.1 ± 14.9 months; P < .001). Discussion Robotic hiatal hernia repair offers technical advantages over laparoscopic repair with similar clinical outcomes.

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“…Proponents of the robotic approach identify the 3-dimensional visualization, favorable surgical ergonomics, and improved instrument maneuverability as having considerable potential to facilitate safe dissection and durable crural repair within the limited confines of the upper abdomen and mediastinum. [6][7][8] Examinations of the effects of robotic-assisted approaches in other general surgical procedures have found equivalent postoperative clinical outcomes when these approaches are compared with standard laparoscopy, but have also consistently identified substantial learning curves, increased operative times, and increased costs associated with the robotic approach. 9,10 To date, the empiric comparisons of robotic-assisted DHR with laparoscopic DHR have been limited.…”

mentioning

confidence: 99%