Robotic-Assisted Paraesophageal Hernia Repair: Initial Experience at a Single Institution.
Publication/Presentation Date
4-1-2016
Abstract
BACKGROUND: Laparoscopic surgery is considered the standard approach for the treatment of paraesophageal hernias (PEHs). Despite its advantages, this approach is technically demanding with a significant learning curve. Data about the safety and utility of the robotically assisted paraesophageal hernia repair (RA-PEHR) are scarce. The aim of this study is to assess the feasibility and safety of robotic assistance for the treatment of PEH.
MATERIALS AND METHODS: Between June 2010 and December 2015, patients who underwent elective RA-PEHR were included in a prospectively collected database. Demographic data, American Society of Anesthesiologists (ASA) classification, preoperative testing, operative time (OT), length of hospital stay (LOS), conversion rate, morbidity, and mortality were recorded and reviewed retrospectively.
RESULTS: Sixty-one patients underwent RA-PEHR with mesh, 72% were female (mean age of 63 and mean body mass index [BMI] of 30). ASA classification was 2.6 (57% of patients had an ASA III). With respect to the type of the hernia, the preoperative diagnosis was: Type II 26%, III 64%, and IV 13%. OT averaged 186 minutes (88-360), including robot setup time. After the 16th case, OT significantly decreased by 4.09 minutes (P = .01). There were no conversions. The average blood loss was 51 mL. Perioperative complications, including intraoperative and 30-day complications, were 6% and 23%, respectively. The mean length of hospitalization was 2.6 (1-18) days. There were no deaths. Forty patients (66%) were available for follow-up, and length of follow-up was 17 ± 15 months. Anatomic recurrence was observed in 42% of patients and only 23% of patients were symptomatic.
CONCLUSIONS: This report represents the largest series to date of RA-PEHR. RA-PEHR has proved to be feasible and safe with a learning curve comparable to the standard laparoscopic approach.
Volume
26
Issue
4
First Page
290
Last Page
295
ISSN
1557-9034
Published In/Presented At
Galvani, C. A., Loebl, H., Osuchukwu, O., Samamé, J., Apel, M. E., & Ghaderi, I. (2016). Robotic-Assisted Paraesophageal Hernia Repair: Initial Experience at a Single Institution. Journal of laparoendoscopic & advanced surgical techniques. Part A, 26(4), 290–295. https://doi.org/10.1089/lap.2016.0096
Disciplines
Medicine and Health Sciences
PubMedID
27035739
Department(s)
Fellows and Residents
Document Type
Article