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Robotic-assisted foregut surgery is associated with lower rates of complication and shorter post-operative length of stay

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Abstract

Background

Two of the most common foregut operations are laparoscopic Heller myotomy and laparoscopic Nissen fundoplication. Robotic assistance, compared to standard laparoscopic approach, may potentially grant surgeons advantages such as enhanced visualization and dexterity. This study compares patient outcomes for Heller myotomy (HM) and Nissen fundoplication (NF) when performed laparoscopically versus robotically.

Methods

A retrospective review of patients at a single institution who underwent laparoscopic or robotic-assisted HM or NF from January 2019 to July 2022 was conducted. 123 HM (72 laparoscopic, 51 robotic-assisted) and 92 NF (62 laparoscopic, 30 robotic-assisted) were performed by three surgeons. Outcomes investigated were operative time, hospital length of stay, pre- and post-operative imaging, resolution of symptoms at 30 days, resolution of symptoms at 90 days, and complications.

Results

In the HM cohorts, the average operative time was longer in the robotic cohort (127 min robotic versus 108 min laparoscopic, p < 0.01). However, overall complication rates (p < 0.05) were lower, and hospital length of stay was shorter in the robotic group (1.5 days compared to 2.7 days, p < 0.001). In the NF cohorts, there was no significant difference in operative time. However, hospital length of stay was shorter in the robotic group (1.54 days compared to 2.7 days, p < 0.001) with otherwise similar outcomes. There was no difference in the rate of post-operative resolution of symptoms or need for additional interventions in either HM or NF.

Conclusion

Robotic-assisted HM and NF are associated with shorter hospital stays compared to their respective laparoscopic approaches. Robotic-assisted HM also has a lower rate of complications. Our findings suggest that robotic assistance may be beneficial for shortening hospital length of stay and decreasing complications for certain surgeries specific to Foregut surgery.

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Authors and Affiliations

  1. University of South Florida Health Morsani College of Medicine, Tampa, FL, USA

    Langfeier Liu & Nicholas Lewis

  2. Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Rahul Mhaskar

  3. Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Joseph Sujka & Christopher DuCoin

  4. Division of Gastrointestinal Surgery, University of South Florida Morsani College of Medicine, 5 Tampa General Circle, Tampa, FL, 33606, USA

    Christopher DuCoin

Authors
  1. Langfeier Liu
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  2. Nicholas Lewis
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  5. Christopher DuCoin
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Correspondence to Christopher DuCoin.

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Disclosures

Christopher DuCoin is a consultant for Medtronic and provides educational services for Intuitive and Boston Sci. Langfeier Liu, Nicholas Lewis, Rahul Mhaskar, and Joseph Sujka have no conflicts of interest or financial ties to disclose.

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Liu, L., Lewis, N., Mhaskar, R. et al. Robotic-assisted foregut surgery is associated with lower rates of complication and shorter post-operative length of stay. Surg Endosc 37, 2800–2805 (2023). https://doi.org/10.1007/s00464-022-09814-6

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  • DOI: https://doi.org/10.1007/s00464-022-09814-6

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