Robotic Fundoplication for Gastroesophageal Reflux Disease and Hiatal Hernia: Initial Experience and Outcome. 2018

Massimo Arcerito, and Eric Changchien, and Monica Falcon, and Mauricio A Parga, and Oscar Bernal, and John T Moon

Gastroesophageal reflux disease, associated with sliding or large paraesophageal hiatal hernia, represents a common clinical presentation. The repair of large paraesophageal hiatal hernias is still a challenge in minimally invasive surgery. Between March 2014 and August 2016, 50 patients (18 males and 32 females) underwent robotic fundoplication (17 sliding and 33 paraesophageal hernias). The mean age of the patients was 58 years. Biosynthetic mesh was used in 28 patients with paraesophageal hernia. The mean operative time was 115 minutes (90-132) in the sliding hiatal hernia group, whereas it was 200 minutes (180-210) in the paraesophageal hiatal hernia group. The mean hospital stay was 36 hours (24-96). Eight patients experienced mild dysphagia which resolved after four weeks. No postoperative dysphagia was recorded at 30-month median follow-up. We experienced one recurrence in the sliding hernia group and two recurrences in the paraesophageal hernia group, with two patients treated robotically. Robotic fundoplication in treating sliding hiatal hernia is feasible and safe but is more challenging in the large paraesophageal group. Improved patient outcomes hinge on the operative technique used and increasing surgeon experience. The increased dexterity that robotic surgery affords enables the esophageal surgeon to more adeptly apply the traditional principles of laparoscopic fundoplication.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D005764 Gastroesophageal Reflux Retrograde flow of gastric juice (GASTRIC ACID) and/or duodenal contents (BILE ACIDS; PANCREATIC JUICE) into the distal ESOPHAGUS, commonly due to incompetence of the LOWER ESOPHAGEAL SPHINCTER. Esophageal Reflux,Gastro-Esophageal Reflux Disease,GERD,Gastric Acid Reflux,Gastric Acid Reflux Disease,Gastro-Esophageal Reflux,Gastro-oesophageal Reflux,Gastroesophageal Reflux Disease,Reflux, Gastroesophageal,Acid Reflux, Gastric,Gastro Esophageal Reflux,Gastro Esophageal Reflux Disease,Gastro oesophageal Reflux,Gastro-Esophageal Reflux Diseases,Reflux Disease, Gastro-Esophageal,Reflux, Gastric Acid,Reflux, Gastro-Esophageal,Reflux, Gastro-oesophageal
D006551 Hernia, Hiatal STOMACH herniation located at or near the diaphragmatic opening for the ESOPHAGUS, the esophageal hiatus. Hernia, Esophageal,Hernia, Paraesophageal,Hiatal Hernia,Esophageal Hernia,Hernia, Hiatus,Paraesophageal Hiatal Hernia,Sliding Esophageal Hernia,Sliding Hiatal Hernia,Esophageal Hernia, Sliding,Esophageal Hernias,Esophageal Hernias, Sliding,Hernia, Paraesophageal Hiatal,Hernia, Sliding Esophageal,Hernia, Sliding Hiatal,Hernias, Esophageal,Hernias, Hiatal,Hernias, Hiatus,Hernias, Paraesophageal,Hernias, Paraesophageal Hiatal,Hernias, Sliding Esophageal,Hernias, Sliding Hiatal,Hiatal Hernia, Paraesophageal,Hiatal Hernia, Sliding,Hiatal Hernias,Hiatal Hernias, Paraesophageal,Hiatal Hernias, Sliding,Hiatus Hernia,Hiatus Hernias,Paraesophageal Hernia,Paraesophageal Hernias,Paraesophageal Hiatal Hernias,Sliding Esophageal Hernias,Sliding Hiatal Hernias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D013526 Surgical Mesh Any woven or knit material of open texture used in surgery for the repair, reconstruction, or substitution of tissue. The mesh is usually a synthetic fabric made of various polymers. It is occasionally made of metal. Mesh, Surgical,Meshes, Surgical,Surgical Meshes

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