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Surgical Treatment of Gastroesophageal Reflux Disease and Upside-down Stomach Using the Da Vinci® Robotic System. A Prospective Study

  • Published:
Journal of Gastrointestinal Surgery

Abstract

So far, the impact of telematic surgical approach in Gastroesophageal Reflux Disease (GERD) is still obscure. In this prospective study, we analyzed the Da Vinci® Intuitive Surgical robotic system for antireflux surgery. In April 2003, we set up a pilot study to evaluate the efficacy of laparoscopic telerobotic surgery using the three-arm Da Vinci® system. Optimal trocar positions, operating and setup times, conversion rate, intraoperative complications, and perioperative morbidity, as well as mortality rate, were analyzed. The median age was 53 years (range 25–74) in 118 patients (52 female/66 male). In 17 patients, an upside-down stomach- and in 101 GERD was surgical indication. The median operating time has been reduced from 105 min to 91 min after 40 procedures and setup time from 24.5 min to 10.4 min after 10 procedures. The system is safe and it seems to be superior to traditional laparoscopy during dissection in the esophageal hiatus region. This compensates long setup- and operating times. Disadvantages are the high costs, the time to master the setup/system and the necessity of exact trocar positioning.

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References

  1. Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R. Laparoscopic Nissen fundoplication: Preliminary report. Surg Laparosc Endosc 1991;1:138–143.

    PubMed  CAS  Google Scholar 

  2. Gould JC, Melvin WS. Computer-assisted robotic antireflux surgery. Surg Laparosc Endosc Percutan Tech 2002;12:26–29.

    Article  PubMed  Google Scholar 

  3. Hubens G, Coveliers H, Balliu L, Ruppert M, Vaneerdeweg W. A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system. Surg Endosc 2003;17:1595–1599.

    Article  PubMed  CAS  Google Scholar 

  4. Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J. Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 2001;25:1467–1477.

    PubMed  CAS  Google Scholar 

  5. Cadiere GB, Himpens J, Vertruyen M, Bruyns J, Germay O, Leman G, Izizaw R. Evaluation of telesurgical (robotic) NISSEN fundoplication. Surg Endosc 2001;15:918–923.

    Article  PubMed  CAS  Google Scholar 

  6. Braumann C, Menenakos C, Rueckert JC, Mueller JM, Jacobi CA. Computer-assisted laparoscopic repair of “upside-down” stomach with the Da Vinci system. Surg Laparosc Endosc Percutan Tech 2005;15:285–289.

    Article  PubMed  Google Scholar 

  7. Weber PA, Merola S, Wasielewski A, Ballantyne GH. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 2002;45:1689–1694.

    Article  PubMed  Google Scholar 

  8. Weinstein GS, O’malley BW, Jr., Hockstein NG. Transoral robotic surgery: supraglottic laryngectomy in a canine model. Laryngoscope 2005;115:1315–1319.

    Article  PubMed  Google Scholar 

  9. Braumann C, Jacobi CA, Menenakos C, Borchert U, Rueckert JC, Mueller JM. Computer-assisted laparoscopic colon resection with the Da Vinci system: Our first experiences. Dis Colon Rectum 2005;48:1820–1827.

    Article  PubMed  Google Scholar 

  10. Ruurda JP, Gooszen HG, Broeders IA. Early experience in robot-assisted laparoscopic Heller myotomy. Scand J Gastroenterol Suppl 2004;4–8.

  11. Nguyen NT, Hinojosa MW, Finley D, Stevens M, Paya M. Application of robotics in general surgery: Initial experience. Am Surg 2004;70:914–917.

    PubMed  Google Scholar 

  12. Gould JC, Melvin WS. Telerobotic foregut and esophageal surgery. Surg Clin North Am 2003;83:1421–1427.

    Article  PubMed  Google Scholar 

  13. Bodner JC, Zitt M, Ott H, Wetscher GJ, Wykypiel H, Lucciarini P, Schmid T. Robotic-assisted thoracoscopic surgery (RATS) for benign and malignant esophageal tumors. Ann Thorac Surg 2005;80:1202–1206.

    Article  PubMed  Google Scholar 

  14. Jacobsen G, Berger R, Horgan S. The role of robotic surgery in morbid obesity. J Laparoendosc Adv Surg Tech Part A 2003;13:279–283.

    Article  Google Scholar 

  15. Artuso D, Wayne M, Grossi R. Use of robotics during laparoscopic gastric bypass for morbid obesity. J Soc Laparaendosc Surg 2005;9:266–268.

    Google Scholar 

  16. Moser F, Horgan S. Robotically assisted bariatric surgery. Am J Surg 2004;188:38S–44S.

    Article  PubMed  Google Scholar 

  17. Parini U, Fabozzi M, Brachet CR, Millo P, Loffredo A, Allieta R, Nardi M, Jr., Lale-Murix E. Laparoscopic gastric bypass performed with the Da Vinci Intuitive Robotic System: Preliminary experience. Surg Endosc 2006;20:1851–1857.

    Article  Google Scholar 

  18. Mohr CJ, Nadzam GS, Alami RS, Sanchez BR, Curet MJ. Totally robotic laparoscopic Roux-en-Y Gastric bypass: results from 75 patients. Obes Surg 2006;16:690–696.

    Article  PubMed  Google Scholar 

  19. Hanly EJ, Talamini MA. Robotic abdominal surgery. Am J Surg 2004;188:19S–26S.

    Article  PubMed  Google Scholar 

  20. Desai MM, Gill IS, Kaouk JH, Matin SF, Sung GT, Bravo EL. Robotic-assisted laparoscopic adrenalectomy. Urology 2002;60:1104–1107.

    Article  PubMed  Google Scholar 

  21. Tanna N, Joshi AS, Glade RS, Zalkind D, Sadeghi N. Da Vinci robot-assisted endocrine surgery: Novel applications in otolaryngology. Otolaryngol Head Neck Surg 2006;135:633–635.

    Article  PubMed  Google Scholar 

  22. McLeod IK, Mair EA, Melder PC. Potential applications of the da Vinci minimally invasive surgical robotic system in otolaryngology. Ear Nose Throat J 2005;84:483–487.

    PubMed  Google Scholar 

  23. Anderberg M, Kockum CC, Arnbjörnsson E. Robotic fundoplication in children. Pediatr Surg Int 2007;23:123–127

    Article  PubMed  Google Scholar 

  24. Lehnert M, Richter B, Beyer PA, Heller K. A prospective study comparing operative time in conventional laparoscopic and robotically assisted Thal semifundoplication in children. J Pediatr Surg 2006;41:1392–1396.

    Article  PubMed  Google Scholar 

  25. Knight CG, Lorincz A, Gidell KM, Lelli J, Klein MD, Langenburg SE. Computer-assisted robot-enhanced laparoscopic fundoplication in children. J Pediatr Surg 2004;39:864–866.

    Article  PubMed  Google Scholar 

  26. Corcione F, Esposito C, Cuccurullo D, Settembre A, Miranda N, Amato F, Pirozzi F, Caiazzo P. Advantages and limits of robot-assisted laparoscopic surgery: Preliminary experience. Surg Endosc 2005;19:117–119.

    Article  PubMed  CAS  Google Scholar 

  27. Hanisch E, Markus B, Gutt C, Schmandra TC, Encke A. [Robot-assisted laparoscopic cholecystectomy and fundoplication—initial experiences with the Da Vinci system]. Chirurg 2001;72:286–288.

    Article  PubMed  CAS  Google Scholar 

  28. Morino M, Pellegrino L, Giaccone C, Garrone C, Rebecchi F. Randomized clinical trial of robot-assisted versus laparoscopic Nissen fundoplication. Br J Surg 2006;93:553–558.

    Article  PubMed  CAS  Google Scholar 

  29. Draaisma WA, Ruurda JP, Scheffer RC, Simmermacher RK, Gooszen HG, Rijnhart-de Jong HG, Buskens E, Broeders IA. Randomized clinical trial of standard laparoscopic versus robot-assisted laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease. Br J Surg 2006;93:1351–1359.

    Article  PubMed  CAS  Google Scholar 

  30. Nakadi IE, Melot C, Closset J, De M, V, Betroune K, Feron P, Lingier P, Gelin M. Evaluation of da Vinci Nissen Fundoplication Clinical Results and Cost Minimization. World J Surg 2006 (abstract).

  31. Melvin WS, Needleman BJ, Krause KR, Schneider C, Ellison EC. Computer-enhanced vs. standard laparoscopic antireflux surgery. J Gastrointest Surg 2002;6:11–15.

    Article  PubMed  Google Scholar 

  32. Hubens G, Ruppert M, Balliu L, Vaneerdeweg W. What have we learnt after two years working with the da Vinci robot system in digestive surgery? Acta Chir Belg 2004;104:609–614.

    PubMed  CAS  Google Scholar 

  33. Newlin ME, Mikami DJ, Melvin SW. Initial experience with the four-arm computer-enhanced telesurgery device in foregut surgery. J Laparoendosc Adv Surg Tech Part A 2004;14:121–124.

    Article  Google Scholar 

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Correspondence to Jens Hartmann.

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Hartmann, J., Jacobi, C.A., Menenakos, C. et al. Surgical Treatment of Gastroesophageal Reflux Disease and Upside-down Stomach Using the Da Vinci® Robotic System. A Prospective Study. J Gastrointest Surg 12, 504–509 (2008). https://doi.org/10.1007/s11605-007-0400-z

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  • DOI: https://doi.org/10.1007/s11605-007-0400-z

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