Clinical analysis of 152 cases of robot-assisted esophageal hiatal hernia repair

WANG Ji; MA Hong-qin; LIU Li; DU Yu-sheng; ZHAO Wen-xing

doi:10.19538/j.cjps.issn1005-2208.2024.04.17

Abstract：Objective To investigate the safety and efficacy of Da Vinci robotic-assisted hiatal hernia repair surgery,and to summarize the experience based on single-center data.Methods The clinical data of 152 patients who underwent robotic-assisted hiatal hernia repair surgery by the same team in the General Surgery Department of the Affiliated Hospital ofXuzhou Medical University from December 2019 to November 2023 were retrospectively analyzed.Improvements in post-operative symptoms were assessed using the Gastroesophageal Reflux Disease Questionnaire(GerdQ).The learning curve was analyzed through the cumulative sum analysis method of operation time(CUSUMOT).Results All 152 patients successfully underwent the surgical procedure,with an operative time of(98.9±38.1)minutes,and intraoperative blood loss of(46.7±19.4)mL.There were no cases requiring blood transfusion,conversion to open or laparoscopic surgery,or serious intraoperative complications.The post-operative hospital stay averaged(2.0±1.2)days,with no occurrences of severe complications classified as Clavien-Dindo grade ≥Ⅲ.All patients completed follow-up:three months post-operation,5 cases(3.3％)experienced dysphagia,4 cases(2.63％)reported diarrhea,and the post-operative GerdQ score significantly decreased compared to pre-operation[(6.4±0.9)vs.(11.1±3.4),P＜0.05].There were no symptomatic or anatomical recurrences three months post-operation.The peak of the learning curve was observed between the 4th and 5th patients,after which the operative time substantially decreased and remained stable.Conclusion The learning curve for Da Vinci robotic-assisted hiatal hernia repair surgery is short.The procedure is safe and effective.