ROBOTIC ASSISTED HIATAL HERNIA REPAIR: A SINGLE SURGEON EXPERIENCE AT HIGH VOLUME COMMUNITY HOSPITAL
YI WANG*, Amir Guindi, Anastasius Peter
Surgery, UPMC Central PA, Harrisburg, PA
Background:
Robotic assisted surgery has been proven to be feasible and safe for hiatal hernia repair in the last decade. This study evaluates the safety and effectiveness of Robotic assisted hiatal hernia repair and fundoplication by a single surgeon at a high-volume community hospital.
Method:
This retrospective observational cohort study includes111 consecutive patients who underwent Robotic assisted hiatal hernia repair from January 2018 to February 2022. The patient demographic and clinical data as well as their short-term outcomes including post-operative complications, length of stay, 30-day readmission and recurrence were reviewed retrospectively.
Results:
The mean patient age was 63.3±14.4 with 74% females. The mean BMI was 30.9±5.0. Seventy (63.6%) patients had either Type III or Type IV hiatal hernia. Ninety-four percent of the patients underwent elective surgery. About 96% (n=106) patients underwent Nissen fundoplication. The mean Robotic console time was 181±52 minutes. The median length of hospital stay was 2 days. The reported outcomes included 11% readmission rate, 5.4% recurrence rate,17.1% postoperative complication rate with 2.7% of major complications (n=3), and 0% mortality rate. Patients who were readmitted had a significantly higher percentage of high ASA scores (ASA>2), 91.7% vs. 53.5%, p=0.0116. Eighty-two patients underwent 12-month follow-up EGD and/or UGI. Our short-term outcomes were similar or superior to the recent robotic and laparoscopic results reported in the literature.
Conclusion:
This study has confirmed that robotic assisted hiatal hernia repair is safe, feasible and effective in our community hospital. Further studies are undergoing to determine the long-term outcomes and quality of life of patients.
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