Robotic systems for minimally invasive surgery may be of added value during dissection and suturing in confined spaces.
Dr Draaisma and colleagues compared standard laparoscopic Nissen fundoplication with robot-assisted Nissen fundoplication.
The research team evaluated 50 patients with confirmed refractory gastro-oesophageal reflux disease (GERD).
The team reported that 25 patients were assigned to laparoscopic Nissen fundoplication, and 25 to robot-assisted Nissen fundoplication.
Patients who had undergone previous antireflux surgery were excluded.
Independent assessment of dysphagia, regurgitation, heartburn and general well-being was performed before and 6 months after surgery using questionnaires.
|Self-rated change in reflux symptoms improved equally in both groups|
|British Journal of Surgery|
The researchers studied objective outcomes by esophageal manometry, 24-hour pH monitoring, barium oesophagram series and upper endoscopy.
The team found that operating time, blood loss, postoperative pain scores, hospital stay and complication rates did not differ between the 2 groups.
Reoperation rates were the same between the groups.
The team noted that postoperative self-rated change in reflux symptoms and quality of life improved equally in both groups.
The reduction in esophageal acid exposure, and increase in lower esophageal sphincter tone were similar in both groups.
The researchers observed that mucosal healing was comparable in both groups at follow-up.
Dr Draaisma's team concludes , “Robot-assisted Nissen fundoplication yielded similar subjective and objective results to laparoscopic Nissen fundoplication in this study.”
“Therefore no additive value of robotic systems for this procedure was detected up to 6 months after surgery.”