Robotic-assisted paraesophageal hernia repair--a case-control study

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Gastrointestinal Surgery

Background:

• The da Vinci® system offers enhanced precision and visualization for complex procedures.
• Large hiatal hernia with paraesophageal involvement (PEH) repair is challenging.
• Limited data exists on robotic-assisted PEH repair and its comparison to standard techniques.

Purpose of the Study:

• To evaluate the feasibility and safety of robotic-assisted surgery (RAS) for PEH repair.
• To compare RAS with conventional laparoscopic surgery (CLS) and open surgery (OS).

Main Methods:

• A comparative study of 42 patients undergoing PEH repair.
• Groups included robotic-assisted surgery (RAS, n=12), conventional laparoscopic surgery (CLS, n=17), and open surgery (OS, n=13).
• Perioperative outcomes analyzed: operating time, blood loss, complications, and hospital stay.

Main Results:

• RAS showed significantly lower intraoperative blood loss and shorter hospital stays compared to OS.
• Postoperative complication rates were lower in RAS than OS, similar to CLS.
• Operating time for RAS was longer than OS but similar to CLS.

Conclusions:

• Robotic-assisted surgery (RAS) is a feasible and safe alternative for PEH repair.
• RAS offers benefits over open surgery (OS) including reduced blood loss and hospital stay.
• RAS is not demonstrably superior to conventional laparoscopic surgery (CLS).