Robot-assisted hiatal hernia repair demonstrates favorable short-term outcomes compared to laparoscopic hiatal hernia repair
Background We postulated that the use of robotics may improve outcomes in hiatal hernia repair. Methods We performed a retrospective analysis of a prospectively collected Society of Thoracic Surgery database at a single institution of patients who underwent elective hiatal hernia repair from 2012 to...
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| Veröffentlicht in: | Surgical endoscopy 2020-06, Vol.34 (6), p.2495-2502 |
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| creator | Soliman, Basem G. Nguyen, Duc T. Chan, Edward Y. Chihara, Ray K. Meisenbach, Leonora M. Graviss, Edward A. Kim, Min P. |
| description | Background
We postulated that the use of robotics may improve outcomes in hiatal hernia repair.
Methods
We performed a retrospective analysis of a prospectively collected Society of Thoracic Surgery database at a single institution of patients who underwent elective hiatal hernia repair from 2012 to 2017 using either laparoscopy or the da Vinci Xi robot. We compared patient characteristics and outcomes and then performed univariate and multivariate logistic regression modeling to determine the factors associated with postoperative morbidity.
Results
There were 293 consecutive patients who underwent elective hiatal hernia repair using either a laparoscopic (
n
= 151) or a robotic (
n
= 142) technique. There were no significant differences in age, gender, BMI, smoking history, presence of comorbidity, or hiatal hernia type. Seventy percent of the cases were a repair of either type III or type IV hiatal hernia. There were significantly higher ASA III and IV (7.9% vs. 4.2%,
P
= 0.03), higher Toupet fundoplication (83.4% vs. 44.4%,
P |
| doi_str_mv | 10.1007/s00464-019-07055-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2268938298</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2268938298</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-e137219b199a67aae90a2183becba59105b238ed4471b577ccf8ef292075ae963</originalsourceid><addsrcrecordid>eNp9kV1rFTEQhoNY7LH6B7yQBW-8iZ0km01yKaV-QEEo9TrM5sx6tuxu1iQrCP54056qIOJNEpgnz8zwMvZCwBsBYM4zQNu1HITjYEBrbh-xnWiV5FIK-5jtwCng0rj2lD3N-RYq74R-wk6VUFaD6Xbsx3XsY-GY85gL7ZvDiAWn5kBpGbFJtOKYmj3NccklYaHcDPgtJuwnavIhpsILpbmJWwlxrtV6rpiqqMRmwvqMOcR1DP8UP2MnA06Znj_cZ-zzu8ubiw_86tP7jxdvr3hQRhdOQhkpXC-cw84gkgOsC6qeQo_aCdC9VJb2bWtEr40JYbA0SCfB6Ap36oy9PnrXFL9ulIufxxxomnChuGUvZWedstLZir76C72NW1rqdPdUq60DXSl5pELdLyca_JrGGdN3L8DfZeOP2fiajb_Pxt-pXz6ot36m_e8vv8KogDoCuZaWL5T-9P6P9ie8GpvW</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2268458905</pqid></control><display><type>article</type><title>Robot-assisted hiatal hernia repair demonstrates favorable short-term outcomes compared to laparoscopic hiatal hernia repair</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Soliman, Basem G. ; Nguyen, Duc T. ; Chan, Edward Y. ; Chihara, Ray K. ; Meisenbach, Leonora M. ; Graviss, Edward A. ; Kim, Min P.</creator><creatorcontrib>Soliman, Basem G. ; Nguyen, Duc T. ; Chan, Edward Y. ; Chihara, Ray K. ; Meisenbach, Leonora M. ; Graviss, Edward A. ; Kim, Min P.</creatorcontrib><description>Background
We postulated that the use of robotics may improve outcomes in hiatal hernia repair.
Methods
We performed a retrospective analysis of a prospectively collected Society of Thoracic Surgery database at a single institution of patients who underwent elective hiatal hernia repair from 2012 to 2017 using either laparoscopy or the da Vinci Xi robot. We compared patient characteristics and outcomes and then performed univariate and multivariate logistic regression modeling to determine the factors associated with postoperative morbidity.
Results
There were 293 consecutive patients who underwent elective hiatal hernia repair using either a laparoscopic (
n
= 151) or a robotic (
n
= 142) technique. There were no significant differences in age, gender, BMI, smoking history, presence of comorbidity, or hiatal hernia type. Seventy percent of the cases were a repair of either type III or type IV hiatal hernia. There were significantly higher ASA III and IV (7.9% vs. 4.2%,
P
= 0.03), higher Toupet fundoplication (83.4% vs. 44.4%,
P
< 0.001), and lower redo-repair (7.3% vs. 20.4%,
P
= 0.001) in the laparoscopic group compared to the robotic group. The hospital length of stay was significantly shorter (1.3 ± 1.8 vs. 1.8 ± 1.5 days,
P
= 0.003) and there were significantly lower rates of complications (6.3 vs. 19.2%,
P
= 0.001) after robotic compared to laparoscopic hiatal hernia repair. There was no difference in readmission rate and mortality. Multiple logistic regression analysis showed that older age and laparoscopic technique were associated with higher complications after surgery.
Conclusion
The use of the Da Vinci Xi robot in our institution was associated with improved outcomes compared to laparoscopic hiatal hernia repair despite a higher incidence of re-operative cases in the robotic group. Thus, short-term outcomes of Da Vinci Xi robot-assisted hiatal hernia repair are not inferior to laparoscopic hiatal hernia repair. Further studies are needed to determine if Da Vinci Xi robot provides superior short-term and long-term outcome in treatment of symptomatic hiatal hernia.</description><identifier>ISSN: 0930-2794</identifier><identifier>ISSN: 1432-2218</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-019-07055-8</identifier><identifier>PMID: 31385076</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Female ; Fundoplication - methods ; Gastroenterology ; Gynecology ; Hepatology ; Hernia, Hiatal - surgery ; Hernias ; Herniorrhaphy - methods ; Humans ; Laparoscopy ; Laparoscopy - methods ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Postoperative Period ; Proctology ; Retrospective Studies ; Robotic Surgical Procedures - methods ; Robotics ; Robots ; Short term ; Surgery ; Thoracic surgery ; Treatment Outcome</subject><ispartof>Surgical endoscopy, 2020-06, Vol.34 (6), p.2495-2502</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-e137219b199a67aae90a2183becba59105b238ed4471b577ccf8ef292075ae963</citedby><cites>FETCH-LOGICAL-c375t-e137219b199a67aae90a2183becba59105b238ed4471b577ccf8ef292075ae963</cites><orcidid>0000-0003-0941-8609</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-019-07055-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-019-07055-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27915,27916,41479,42548,51310</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31385076$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soliman, Basem G.</creatorcontrib><creatorcontrib>Nguyen, Duc T.</creatorcontrib><creatorcontrib>Chan, Edward Y.</creatorcontrib><creatorcontrib>Chihara, Ray K.</creatorcontrib><creatorcontrib>Meisenbach, Leonora M.</creatorcontrib><creatorcontrib>Graviss, Edward A.</creatorcontrib><creatorcontrib>Kim, Min P.</creatorcontrib><title>Robot-assisted hiatal hernia repair demonstrates favorable short-term outcomes compared to laparoscopic hiatal hernia repair</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
We postulated that the use of robotics may improve outcomes in hiatal hernia repair.
Methods
We performed a retrospective analysis of a prospectively collected Society of Thoracic Surgery database at a single institution of patients who underwent elective hiatal hernia repair from 2012 to 2017 using either laparoscopy or the da Vinci Xi robot. We compared patient characteristics and outcomes and then performed univariate and multivariate logistic regression modeling to determine the factors associated with postoperative morbidity.
Results
There were 293 consecutive patients who underwent elective hiatal hernia repair using either a laparoscopic (
n
= 151) or a robotic (
n
= 142) technique. There were no significant differences in age, gender, BMI, smoking history, presence of comorbidity, or hiatal hernia type. Seventy percent of the cases were a repair of either type III or type IV hiatal hernia. There were significantly higher ASA III and IV (7.9% vs. 4.2%,
P
= 0.03), higher Toupet fundoplication (83.4% vs. 44.4%,
P
< 0.001), and lower redo-repair (7.3% vs. 20.4%,
P
= 0.001) in the laparoscopic group compared to the robotic group. The hospital length of stay was significantly shorter (1.3 ± 1.8 vs. 1.8 ± 1.5 days,
P
= 0.003) and there were significantly lower rates of complications (6.3 vs. 19.2%,
P
= 0.001) after robotic compared to laparoscopic hiatal hernia repair. There was no difference in readmission rate and mortality. Multiple logistic regression analysis showed that older age and laparoscopic technique were associated with higher complications after surgery.
Conclusion
The use of the Da Vinci Xi robot in our institution was associated with improved outcomes compared to laparoscopic hiatal hernia repair despite a higher incidence of re-operative cases in the robotic group. Thus, short-term outcomes of Da Vinci Xi robot-assisted hiatal hernia repair are not inferior to laparoscopic hiatal hernia repair. Further studies are needed to determine if Da Vinci Xi robot provides superior short-term and long-term outcome in treatment of symptomatic hiatal hernia.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Fundoplication - methods</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hernia, Hiatal - surgery</subject><subject>Hernias</subject><subject>Herniorrhaphy - methods</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Postoperative Period</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotics</subject><subject>Robots</subject><subject>Short term</subject><subject>Surgery</subject><subject>Thoracic surgery</subject><subject>Treatment Outcome</subject><issn>0930-2794</issn><issn>1432-2218</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kV1rFTEQhoNY7LH6B7yQBW-8iZ0km01yKaV-QEEo9TrM5sx6tuxu1iQrCP54056qIOJNEpgnz8zwMvZCwBsBYM4zQNu1HITjYEBrbh-xnWiV5FIK-5jtwCng0rj2lD3N-RYq74R-wk6VUFaD6Xbsx3XsY-GY85gL7ZvDiAWn5kBpGbFJtOKYmj3NccklYaHcDPgtJuwnavIhpsILpbmJWwlxrtV6rpiqqMRmwvqMOcR1DP8UP2MnA06Znj_cZ-zzu8ubiw_86tP7jxdvr3hQRhdOQhkpXC-cw84gkgOsC6qeQo_aCdC9VJb2bWtEr40JYbA0SCfB6Ap36oy9PnrXFL9ulIufxxxomnChuGUvZWedstLZir76C72NW1rqdPdUq60DXSl5pELdLyca_JrGGdN3L8DfZeOP2fiajb_Pxt-pXz6ot36m_e8vv8KogDoCuZaWL5T-9P6P9ie8GpvW</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Soliman, Basem G.</creator><creator>Nguyen, Duc T.</creator><creator>Chan, Edward Y.</creator><creator>Chihara, Ray K.</creator><creator>Meisenbach, Leonora M.</creator><creator>Graviss, Edward A.</creator><creator>Kim, Min P.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0941-8609</orcidid></search><sort><creationdate>20200601</creationdate><title>Robot-assisted hiatal hernia repair demonstrates favorable short-term outcomes compared to laparoscopic hiatal hernia repair</title><author>Soliman, Basem G. ; Nguyen, Duc T. ; Chan, Edward Y. ; Chihara, Ray K. ; Meisenbach, Leonora M. ; Graviss, Edward A. ; Kim, Min P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-e137219b199a67aae90a2183becba59105b238ed4471b577ccf8ef292075ae963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Fundoplication - methods</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hernia, Hiatal - surgery</topic><topic>Hernias</topic><topic>Herniorrhaphy - methods</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Postoperative Period</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotics</topic><topic>Robots</topic><topic>Short term</topic><topic>Surgery</topic><topic>Thoracic surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soliman, Basem G.</creatorcontrib><creatorcontrib>Nguyen, Duc T.</creatorcontrib><creatorcontrib>Chan, Edward Y.</creatorcontrib><creatorcontrib>Chihara, Ray K.</creatorcontrib><creatorcontrib>Meisenbach, Leonora M.</creatorcontrib><creatorcontrib>Graviss, Edward A.</creatorcontrib><creatorcontrib>Kim, Min P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soliman, Basem G.</au><au>Nguyen, Duc T.</au><au>Chan, Edward Y.</au><au>Chihara, Ray K.</au><au>Meisenbach, Leonora M.</au><au>Graviss, Edward A.</au><au>Kim, Min P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robot-assisted hiatal hernia repair demonstrates favorable short-term outcomes compared to laparoscopic hiatal hernia repair</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>34</volume><issue>6</issue><spage>2495</spage><epage>2502</epage><pages>2495-2502</pages><issn>0930-2794</issn><issn>1432-2218</issn><eissn>1432-2218</eissn><abstract>Background
We postulated that the use of robotics may improve outcomes in hiatal hernia repair.
Methods
We performed a retrospective analysis of a prospectively collected Society of Thoracic Surgery database at a single institution of patients who underwent elective hiatal hernia repair from 2012 to 2017 using either laparoscopy or the da Vinci Xi robot. We compared patient characteristics and outcomes and then performed univariate and multivariate logistic regression modeling to determine the factors associated with postoperative morbidity.
Results
There were 293 consecutive patients who underwent elective hiatal hernia repair using either a laparoscopic (
n
= 151) or a robotic (
n
= 142) technique. There were no significant differences in age, gender, BMI, smoking history, presence of comorbidity, or hiatal hernia type. Seventy percent of the cases were a repair of either type III or type IV hiatal hernia. There were significantly higher ASA III and IV (7.9% vs. 4.2%,
P
= 0.03), higher Toupet fundoplication (83.4% vs. 44.4%,
P
< 0.001), and lower redo-repair (7.3% vs. 20.4%,
P
= 0.001) in the laparoscopic group compared to the robotic group. The hospital length of stay was significantly shorter (1.3 ± 1.8 vs. 1.8 ± 1.5 days,
P
= 0.003) and there were significantly lower rates of complications (6.3 vs. 19.2%,
P
= 0.001) after robotic compared to laparoscopic hiatal hernia repair. There was no difference in readmission rate and mortality. Multiple logistic regression analysis showed that older age and laparoscopic technique were associated with higher complications after surgery.
Conclusion
The use of the Da Vinci Xi robot in our institution was associated with improved outcomes compared to laparoscopic hiatal hernia repair despite a higher incidence of re-operative cases in the robotic group. Thus, short-term outcomes of Da Vinci Xi robot-assisted hiatal hernia repair are not inferior to laparoscopic hiatal hernia repair. Further studies are needed to determine if Da Vinci Xi robot provides superior short-term and long-term outcome in treatment of symptomatic hiatal hernia.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31385076</pmid><doi>10.1007/s00464-019-07055-8</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0941-8609</orcidid></addata></record> |
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| subjects | Abdominal Surgery Adult Aged Female Fundoplication - methods Gastroenterology Gynecology Hepatology Hernia, Hiatal - surgery Hernias Herniorrhaphy - methods Humans Laparoscopy Laparoscopy - methods Male Medicine Medicine & Public Health Middle Aged Postoperative Period Proctology Retrospective Studies Robotic Surgical Procedures - methods Robotics Robots Short term Surgery Thoracic surgery Treatment Outcome |
| title | Robot-assisted hiatal hernia repair demonstrates favorable short-term outcomes compared to laparoscopic hiatal hernia repair |
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