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Robot-assisted laparoscopic partial posterior fundoplication with the DaVinci system: initial experiences and
H Wykypiel1, G J Wetscher, A Klaus
1Department of General Surgery, University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
Langenbeck'S Archives of Surgery
|February 28, 2003
Summary
Robot-assisted surgery for gastroesophageal reflux disease (GERD) using the DaVinci system is safe and effective. This pilot study showed significant symptom improvement and enhanced lower esophageal sphincter function six months post-operation.
Area of Science:
- Minimally Invasive Surgery
- Robotic Surgery
- Gastroenterology
Background:
- The DaVinci surgical robot was evaluated for its role in laparoscopic antireflux surgery.
- Severe gastroesophageal reflux disease (GERD) patients were the focus of this pilot study.
Purpose of the Study:
- To assess the safety and efficacy of robot-assisted laparoscopic Toupet-fundoplication for GERD.
- To compare robotic approach benefits against conventional laparoscopic methods.
Main Methods:
- Nine patients with severe GERD underwent robot-assisted laparoscopic Toupet-fundoplication using the DaVinci system.
- Clinical, endoscopic, and manometric follow-up was conducted at six months in six patients.
Main Results:
- No intraoperative complications were reported. Six months post-surgery, patients experienced no reflux symptoms or acute esophagitis.
- Significant improvement in lower esophageal sphincter function was observed manometrically. Mild transient dysphagia and bloating were reported in two patients.
Conclusions:
- Robot-assisted partial posterior fundoplication is a safe procedure with superior visualization and instrument precision.
- Enhanced intracorporeal suturing, knot tying, and anatomical approximation were noted.
- While effective, robotic surgery presents challenges with cost and setup time.