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Robotic Hiatal Hernia Repair

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Management of Gastroesophageal Reflux Disease

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Abstract

Hiatal hernias present a clinical and anatomical entity that must be fully appreciated for safe and effective management. They are an uncommon form of hiatal hernia that present clinically in the population of patients over 65 years of age. The most common symptomatic presentations of a paraesophageal hernia (PEH) include dysphagia, regurgitation, gastroesophageal reflux, dyspnea, chest or epigastric pain or pressure, and anemia. Robotic repair of a paraesophageal hernia is an efficient and ergonomic approach to this challenging anatomical problem. Added precision and extended accessibility and visualization of the thorax from an abdominal approach makes the robotic repair a preferred surgical method. Paraesophageal hernia repair may be performed via a trans-thoracic or trans-abdominal approach. Open, laparoscopic, and robotic techniques may be applied.

We prefer the robotic system for trans-abdominal paraesophageal hernia repair in our institution for both elective and emergency settings provided a suitable clinical scheme. PEH is a potentially devastating condition frequently manifesting in patients of advanced age with other substantial medical problems. A meta-analysis of 13 studies, including 965 patients reported an overall recurrence of 10.2% and a “true” recurrence rate of 25.5% when a follow-up barium esophagogram was used. Robotic-assisted paraesophageal hernia repair is a safe procedure that has a learning curve of about 36 cases. Upon review of the literature, this approach seems to have the same benefits as those of the laparoscopic approach in terms of total surgical time, complication rate, length of hospital stay, and quality of life.

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Authors and Affiliations

  1. Division of Minimally Invasive Surgery, Department of Surgery, University of California San Diego Medical Center, La Jolla, CA, USA

    Joslin N. Cheverie, Ryan C. Broderick & Robert F. Cubas

  2. University of California San Diego, Department of Surgery, Center for the Future of Surgery, La Jolla, CA, USA

    Ryan C. Broderick

  3. Division of Minimally Invasive Surgery, Department of Surgery, University of California San Diego, La Jolla, CA, USA

    Santiago Horgan

Authors
  1. Joslin N. Cheverie
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  2. Ryan C. Broderick
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  3. Robert F. Cubas
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  4. Santiago Horgan
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Correspondence to Joslin N. Cheverie .

Editor information

Editors and Affiliations

  1. University of California, San Diego, Center for the Future of Surgery, La Jolla, CA, USA

    Santiago Horgan

  2. University of California, San Diego, Center for the Future of Surgery, La Jolla, CA, USA

    Karl-Hermann Fuchs

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Cheverie, J.N., Broderick, R.C., Cubas, R.F., Horgan, S. (2020). Robotic Hiatal Hernia Repair. In: Horgan, S., Fuchs, KH. (eds) Management of Gastroesophageal Reflux Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-48009-7_11

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  • DOI: https://doi.org/10.1007/978-3-030-48009-7_11

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  • Online ISBN: 978-3-030-48009-7

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