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Complications Following Robotic Hiatal Hernia Repair Are Higher Compared to Laparoscopy

  • Original Article
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Journal of Gastrointestinal Surgery

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Abstract

Background

The use of robotic platforms in surgery is becoming increasingly common in both practice and residency training. In this study, we compared the perioperative outcomes between robotic platforms and traditional laparoscopy in paraesophageal hernia repair.

Methods

A retrospective population-based analysis was performed using the National Inpatient Sample for the period of 2010–2015. Adult patients (≥18 years old) who underwent laparoscopic or robotic paraesophageal hernia repairs were included. Weighted multivariable random intercept linear and logistic regression models were used to assess the effects of robotic surgery on patient outcomes.

Results

A total of 168,329 patients were included in the study. The overall adjusted rate of complications was significantly higher in patients who underwent robotic paraesophageal hernia (PEH) repair compared to laparoscopic PEH OR (95% CI) = 1.17 (1.07, 1.27). Specifically, respiratory failure OR (95% CI) = 1.68 (1.37, 2.05) and esophageal perforation OR (95% CI) = 2.19 (1.42, 3.93) were higher in robotic PEH patients. A subset analysis was performed looking at high-volume centers (>20 operations per year), and, although the risk of complications was lower in the high volume centers compared to intermediate volume centers, complication rates were still significantly higher in the robotic surgery group compared to laparoscopic. Overall charges per surgery were significantly higher in the robotic group.

Conclusion

Robotic PEH repair is associated with significantly more complications compared to laparoscopic paraesophageal hernia repair even in high-volume centers.

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Author information

Authors and Affiliations

  1. Center for Advanced Surgery, Baylor Scott and White Health, Dallas, TX, USA

    Marc A. Ward & Steven G. Leeds

  2. Division of Minimally Invasive Surgery, Baylor University Medical Center, 3417 Gaston Avenue, Suite 965 East, TX, 75246, Dallas, USA

    Marc A. Ward, Christine E. Sanchez & Steven G. Leeds

  3. Texas A&M College of Medicine, Bryan, TX, USA

    Marc A. Ward, Salman S. Hasan, Edward P. Whitfield & Steven G. Leeds

  4. Research Institute, Baylor Scott and White Health, Dallas, TX, USA

    Christine E. Sanchez & Gerald O. Ogola

Authors
  1. Marc A. Ward
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  2. Salman S. Hasan
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  3. Christine E. Sanchez
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  4. Edward P. Whitfield
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  5. Gerald O. Ogola
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  6. Steven G. Leeds
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Contributions

MAW, SSH, EPW, and SGL contributed to the design, data acquisition and interpretation, manuscript preparation, critical revision, and final approval; GOO contributed to data acquisition, analysis, and interpretation of results, manuscript preparation, critical revision, and final approval; CES contributed to the interpretation of results, critical revision of the manuscript, and final approval. All authors agree to be accountable for all aspects of this work.

Corresponding author

Correspondence to Marc A. Ward.

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Conflict of Interest

Dr. Steven Leeds is a consultant for Ethicon and Boston Scientific. All other authors have no conflicts of interest or financial disclosures to report.

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Ward, M.A., Hasan, S.S., Sanchez, C.E. et al. Complications Following Robotic Hiatal Hernia Repair Are Higher Compared to Laparoscopy. J Gastrointest Surg 25, 3049–3055 (2021). https://doi.org/10.1007/s11605-021-05005-1

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  • DOI: https://doi.org/10.1007/s11605-021-05005-1

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