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Related Concept Videos

Hiatal Hernia01:25

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...

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Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
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Robotic hiatal hernia repair without mesh.

John K Sadeghi1,2,3,4, Leo T Li1,2,3,4, Vijay A Singh1,3,4

  • 1Department of Thoracic Surgery, Long Island Jewish Medical Center, Queens, NY, USA.

Journal of Thoracic Disease
|February 27, 2024
PubMed
Summary

Robotic hiatal hernia repair without mesh using V-loc™ and silk sutures is safe and effective. This minimally invasive approach demonstrates favorable outcomes, including low recurrence and readmission rates for patients.

Keywords:
Hiatal herniaV-locno meshprimary repairrobotic

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Area of Science:

  • Minimally Invasive Surgery
  • Gastrointestinal Surgery
  • Robotic Surgery

Background:

  • Minimally invasive techniques are increasingly preferred for hiatal hernia repair over traditional open surgery.
  • Limited data exists on outcomes of robotic hiatal hernia repair performed without mesh.
  • This study reports a high-volume experience with robotic hiatal hernia repair using a mesh-free technique.

Purpose of the Study:

  • To evaluate the safety and efficacy of robotic hiatal hernia repair without mesh.
  • To assess outcomes including length of stay, readmission, and recurrence rates.
  • To present a novel technique for hiatus closure during robotic repair.

Main Methods:

  • Retrospective review of 144 patients undergoing elective robotic-assisted hiatal hernia repair (Type I-IV) from 2016-2019.
  • Novel technique involved hiatus approximation with running barbed absorbable (V-loc™) suture and interrupted silk sutures.
  • Key outcomes measured were length of stay, readmission rate, and recurrence rate.

Main Results:

  • The study included 144 patients (66% female), average age 61, average BMI 29.96 kg/m².
  • Average operating time was 173 minutes, with an average length of stay of 2 days.
  • Readmission rate was 6.9%, with a recurrence rate of 4.2% requiring reoperation; no 30-day mortalities were observed.

Conclusions:

  • Robotic hiatal hernia repair with fundoplication and primary hiatus closure (V-loc™ and silk sutures) without mesh is a safe and effective procedure.
  • The robotic approach shows comparable operative times, lengths of stay, and complication rates to laparoscopic methods.
  • This mesh-free robotic technique offers a durable solution for hiatal hernia management.