Laparoscopic fundoplication assisted by robot

Juan Roberto González-Santamaría, María Rubí Valderrama-Gutiérrez, Erick Hiram Rubio Arroyo, Gustavo Alain Flores-Rangel
2018 Digestive System  
For many years, open fundoplication was the standard for the surgical management of gastroesophageal reflux disease (GERD). In the last two decades, laparoscopic surgery has displaced the open approach by achieving similar results, with a faster convalescence and less postoperative pain. Robotic technology was recently introduced as an evolution of the conventional laparoscopic, whose role is still to be validated. Material and methods: We describe a retrospective analysis of the initial
more » ... nce in Nissen floppy-type fundoplications performed by a robot assisted approach in the Zumpango's High Specialty Regional Hospital. Results: A total of 18 cases were found from June 2014 to December 2017. The total surgical time was 146 minutes (120 to 203), docking time 10.2 minutes (5 to 20) and console time 108.2 minutes (60 to 153). The hospital stay was 39.4hrs (18 to 192), the perioperative morbidity 11.1%, conversion 5.5%, reoperations 5.5% and death 0%. At 19.4 months of follow-up, 84.6% presented remission or improvement of the initial symptoms of GERD (Visick I, II), 15.4% reported no changes (Visick III), and no patient reported increased symptoms (ViscickIV). The morbidity and conversion of the first 9 cases was 22.2% and 11.1% respectively, while in the following 9 cases it was 0% and 0%. Discussion: Our initial experience with robot-assisted fundoplications shows comparable results with the reported standards in the medical literature for any approach. The probability of conversion and the incidence of complications are inversely proportional to the accumulated experience, due to the robotic approach requires an aggregate learning curve. González-Santamaría JR (2018) Laparoscopic fundoplication assisted by robot Volume 2(2): 2-4 Despite this learning curve, our results are competitive with the experience reported in the medical literature, both conventional laparoscopic and robot-assisted approaches.
doi:10.15761/dsj.1000121 fatcat:4e4cza3b7jaitdes52rwtu37yu