BACKGROUND: This pilot study evaluated the role of the DaVinci operation robot for laparoscopic antireflux surgery. PATIENTS AND METHODS: A robot-assisted laparoscopic Toupet-fundoplication was performed on nine consecutive patients with severe gastroesophageal reflux disease using the DaVinci robot system. The operative procedure was performed in the same way as for the conventional laparoscopic procedure. Clinical assessment and endoscopic and manometric follow-up investigations were performed 6 months after surgery in six of the patients. RESULTS: The mean robotic operative time was 173 min (120-235). A mean of 25 min (12-45) was required to establish the pneumoperitoneum, to set the trocars, and to place the robot arms. There were no intraoperative complications. Six months after surgery none of the patients suffered from reflux symptoms and none of the patients had acute esophagitis. Postoperatively one patient complained of mild transient dysphagia. However, persistent dysphagia was not found in any of the patients. One further patient complained of mild bloating. No other side effects occurred. Manometrically there was a significant improvement in the function of the lower esophageal sphincter. CONCLUSIONS: The robot-assisted partial posterior fundoplication is a safe procedure and provides a high-quality three-dimensional camera image that is superior to that with the conventional laparoscopic device. The handling of the instruments is precise, and intracorporeal suturing and knot tying is much easier than without the robotic technique. The procedure allows for an accurate approximation of the hiatal crura and for precise construction of the fundic wrap. However, robotic surgery is expensive and the setup of the system is time consuming at present.
BACKGROUND: This pilot study evaluated the role of the DaVinci operation robot for laparoscopic antireflux surgery. PATIENTS AND METHODS: A robot-assisted laparoscopic Toupet-fundoplication was performed on nine consecutive patients with severe gastroesophageal reflux disease using the DaVinci robot system. The operative procedure was performed in the same way as for the conventional laparoscopic procedure. Clinical assessment and endoscopic and manometric follow-up investigations were performed 6 months after surgery in six of the patients. RESULTS: The mean robotic operative time was 173 min (120-235). A mean of 25 min (12-45) was required to establish the pneumoperitoneum, to set the trocars, and to place the robot arms. There were no intraoperative complications. Six months after surgery none of the patients suffered from reflux symptoms and none of the patients had acute esophagitis. Postoperatively one patient complained of mild transient dysphagia. However, persistent dysphagia was not found in any of the patients. One further patient complained of mild bloating. No other side effects occurred. Manometrically there was a significant improvement in the function of the lower esophageal sphincter. CONCLUSIONS: The robot-assisted partial posterior fundoplication is a safe procedure and provides a high-quality three-dimensional camera image that is superior to that with the conventional laparoscopic device. The handling of the instruments is precise, and intracorporeal suturing and knot tying is much easier than without the robotic technique. The procedure allows for an accurate approximation of the hiatal crura and for precise construction of the fundic wrap. However, robotic surgery is expensive and the setup of the system is time consuming at present.
Authors: G J Wetscher; K Glaser; T Wieschemeyer; M Gadenstaetter; R Prommegger; C Profanter Journal: World J Surg Date: 1997 Jul-Aug Impact factor: 3.352
Authors: G B Cadière; J Himpens; O Germay; R Izizaw; M Degueldre; J Vandromme; E Capelluto; J Bruyns Journal: World J Surg Date: 2001-11 Impact factor: 3.352
Authors: T R DeMeester; C I Wang; J A Wernly; C A Pellegrini; A G Little; P Klementschitsch; G Bermudez; L F Johnson; D B Skinner Journal: J Thorac Cardiovasc Surg Date: 1980-05 Impact factor: 5.209
Authors: Dimitrios Stefanidis; William W Hope; Geoffrey P Kohn; Patrick R Reardon; William S Richardson; Robert D Fanelli Journal: Surg Endosc Date: 2010-08-20 Impact factor: 4.584
Authors: M Waseda; N Inaki; J R Torres Bermudez; G Manukyan; I A Gacek; M O Schurr; M Braun; G F Buess Journal: Surg Endosc Date: 2007-05-22 Impact factor: 4.584
Authors: Heinz F Wykypiel; Johannes Bodner; Florian Augustin; Oliver Renz; Elisabeth Hoeller; Thomas Schmid Journal: Wien Klin Wochenschr Date: 2009 Impact factor: 1.704
Authors: Kendell J Sowards; Nicholas F Holton; Ekatarina G Elliott; John Hall; Kulvinder S Bajwa; Brad E Snyder; Todd D Wilson; Sheilendra S Mehta; Peter A Walker; Kavita D Chandwani; Connie L Klein; Angielyn R Rivera; Erik B Wilson; Shinil K Shah; Melissa M Felinski Journal: Surg Endosc Date: 2019-12-06 Impact factor: 4.584