Intraoperative and Postoperative Outcome of Robot-Assisted and Traditional Laparoscopic Nissen Fundoplication

Vol. 43, No. 2, 2009

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Original Paper

Intraoperative and Postoperative Outcome of Robot-Assisted and Traditional Laparoscopic Nissen Fundoplication
G. Ceccarelli, A. Patriti, A. Biancafarina, A. Spaziani, A. Bartoli, R. Bellochi, L. Casciola

Department of General, Vascular, Minimally Invasive and Robotic Surgery, San Matteo degli Infermi Hospital, ASL 3 dell’Umbria, Spoleto, Italy

Address of Corresponding Author

Eur Surg Res 2009;43:198-203 (DOI: 10.1159/000223751)

Key Words

Nissen fundoplication
Robotics
Postoperative outcome

Abstract

Background: Robotics has been proposed as a tool to improve laparoscopic Nissen fundoplication. However, a clear benefit of this technology for minimally invasive antireflux surgery has not been demonstrated. Materials and Methods: A retrospective review of a prospective database was used to compare the intraoperative and postoperative outcome of 137 patients who underwent conventional laparoscopic fundoplication (CLF) and 45 patients who underwent laparoscopic robot-assisted fundoplication (LRF). Intraoperative outcome measures were: operative time, blood loss and complications. Length of hospital stay, functional results and patient satisfaction were used to compare postoperative outcome. Results: Operative time was significantly shorter in the LRF group (65 min) compared to the CLF group (85 min) (p < 0.0001). The overall complication rate was comparable between the two techniques, even though a higher incidence of liver tears was encountered in the CLF group (p < 0.05). Hospital stay, symptom relief and patient satisfaction did not differ between the groups. Conclusion: Robotics improves surgeon dexterity and maneuverability during laparoscopic Nissen fundoplication, but this does not correspond to a better postoperative outcome. LRF should be used only for complex cases and training.

Author Contacts

Graziano Ceccarelli
Department of General, Vascular, Minimally Invasive and Robotic Surgery
San Matteo degli Infermi Hospital
IT–06049 Spoleto (Italy)
Tel./Fax +39 0743 2101, E-Mail g.cecca2003@libero.it

Article Information

Received: July 15, 2008
Accepted after revision: February 10, 2009
Published online: June 10, 2009
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 3, Number of References : 18

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