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Updated: Oct 29, 2025
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Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
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Robotic Complex Fundoplication in Patients at High-Risk to Fail
Kenneth Luberice1, Sharona Ross1, Kaitlyn Crespo1
1Digestive Disorders Institute, AdventHealth Tampa, 3000 Medical Park Dr. Ste 500, Tampa, Florida 33613.
Summary
Robotic fundoplication is safe and effective for complex GERD patients, showing superior outcomes compared to national averages. This advanced surgical approach offers better results for challenging cases.
Area of Science:
- Minimally Invasive Surgery
- Gastroenterology
- Surgical Oncology
Background:
- Robotic fundoplication is increasingly used for gastroesophageal reflux disease (GERD).
- Complex patient populations, including those with prior failed antireflux procedures, giant hiatal hernias, or extensive abdominal mesh, present unique surgical challenges.
- Evaluating outcomes in these complex groups is crucial for establishing the efficacy of robotic surgery.
Purpose of the Study:
- To analyze outcomes of robotic fundoplication in complex GERD patients.
- To compare these outcomes against predicted risks from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) and national NSQIP data.
- To assess the safety and efficacy of robotic platform utilization in challenging fundoplication cases.
Main Methods:
- Prospective follow-up of 100 patients undergoing robotic fundoplication.
- Patients included those with failed antireflux surgery, type IV hiatal hernias, or post-extensive intra-abdominal mesh surgery.
- Outcomes were compared to NSQIP predicted and national reported data.
Main Results:
- Robotic fundoplication in 100 complex patients demonstrated superior outcomes compared to NSQIP predictions and national data for serious complications, overall complications, pneumonia, surgical site infection, deep vein thrombosis, readmission, return to operating room, and sepsis (P < 0.05).
- Actual outcomes were not worse for renal failure, mortality, cardiac complications, or discharge to a nursing facility.
- The patient cohort was complex, exceeding the typical profile reported in NSQIP.
Conclusions:
- Robotic fundoplication is a safe and effective treatment for GERD in complex patient populations.
- The robotic platform facilitates superior outcomes in challenging fundoplication cases compared to predicted and national benchmarks.
- This approach is well-suited for intricate surgical scenarios involving GERD management.
