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2001 Abstract: 620 A Prospective Trial of "Robotic" Fundoplication

2001 Digestive Disease Week

# 620 A Prospective Trial of "Robotic" Fundoplication
W. Scott Melvin, Kevin R. Krause, Bradley J. Needleman, E. Christopher Ellison, Columbus, OH

Computer assisted telesurgical devices have recently become approved to perform advanced laparoscopic procedures. In an effort to determine the safety and efficacy of these procedures, we performed a prospective evaluation of standard laparoscopic (LS) versus robotic (Robo) fundoplication. Consecutive patients undergoing surgical treatment for reflux were included. Patients who had previous anti-reflux procedures were excluded. The operating surgeon worked at a console using a three dimensional image. Hand controls manipulated two multi articulated intracorporeal instruments and the telescope. The assistant surgeon manipulated the accessory instruments. Operative times, complications, and hospital stay were recorded and results compared using a Student's t-test. Twenty patients were entered in each group. There were 18 Nissens and 2 Toupets in each group. There was no difference in age, or pre-operative weight (see Table 1). Operative times were significantly longer in the robotic group. Dividing the Robo cases to account for the learning curve, the last ten operative times (131 min) were significantly faster than the first ten (151min), but remained significantly longer than the LS group. Post-operative stays were similar. There were no perioperative complications. Follow-up was 6-13 months for the LS group and 1-4 months for the robot group. Computer assisted laparoscopic anti-reflux surgery is safe. However, operative times are considerably longer when using this device as compared to laparoscopic procedures, especially early in the learning curve. At the current level of technology, robotic anti-reflux procedures appear to offer little advantage over standard laparoscopic techniques.

Table 1

L/S Robot P value

Age 50 45 N.S.

Weight (lbs) 191 182 N.S.

Operative Time (min) 97 141 P<.008

Length of Stay (days) 1.2 1.3 N.S.

Complications 0 0 N.S.

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