Current Status of the Robotic Fundoplication: Case Series and Literature Review

Juan Roberto González-Santamaría, María Rubí Valderrama-Gutiérrez, Erick Hiram Rubio Arroyo and Gustavo Alain Flores-Rangel

Department of Robotic Surgery and Minimal Invasion, Zumpango High Specialty Regional Hospital, Mexico

^*Correspondance to: Gustavo Alain Flores Rangel 

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Abstract:

Introduction: For many years, open fundoplication was the standard for the surgical management of Gastroesophageal Reflux Disease (GERD). In the last two decades, laparoscopic surgery has displaced the open approach by achieving similar results, with a faster convalescence and less postoperative pain. Robotic technology was recently introduced as an evolution of the conventional laparoscopic, whose role is still to be validated.Material and
Methods: We describe a retrospective analysis of the initial experience in Nissen floppy-type fundoplication performed by a robot assisted approach in the Zumpango's High Specialty Regional Hospital.Results: A total of 18 cases were found from June 2014 to December 2017. The total surgical time was 146 minutes (120 min to 203 min), docking time 10.2 minutes (5 min to 20 min) and console time 108.2 minutes (60 min to 153 min). The hospital stay was 39.4 hrs (18 hr to 192 hr), the perioperative morbidity 11.1%, conversion 5.5%, reoperations 5.5% and death 0%. At 19.4 months of follow-up, 84.6% presented remission or improvement of the initial symptoms of GERD (Visick I, II), 15.4% reported no changes (Visick III), and no patient reported increased symptoms (Visick IV). The morbidity and conversion of the first 9 cases was 22.2% and 11.1% respectively, while in the following 9 cases it was 0% and 0%.Discussion: Our initial experience with robot-assisted fundoplication shows comparable results with the reported standards in the medical literature for any approach. The probability of conversion and the incidence of complications are inversely proportional to the accumulated experience, due to the robotic approach requires an aggregate learning curve.

Keywords:

Reflux; Gastroesophageal; GERD; Robotic; Fundoplication

Cite the Article:

González-Santamaría JR, Valderrama- Gutiérrez MR, Rubio Arroyo EH, Flores- Rangel GA. Current Status of the Robotic Fundoplication: Case Series and Literature Review. Ann Clin Case Rep. 2018; 3: 1548.