Abstract
Abstract In the video we perform the crural robotic reinforcement with de use of biosynthetic mesh (Gore Bio-A) without any funduplication in a 37 years-old woman with a two time hernia hiatal recurrence. Although laparoscopic surgery to treat primary hiatal hernias (HHs) is the gold standard approach, the use of robotic platforms seems to gain weight. This video aims to show the step-by-step in a redo hiatal surgery and the benefits of robotic surgery. Methods Here in the video we present a 37-year old woman patient who underwent previously two laparoscopic Nissen fundoplication because of hiatal hernia and gastroesophageal reflux disease. The first surgery was done in 2015 and the patient needed a laparoscopic redo due to hiatal relapse, done in 2019 with nonabsorbable mesh reinforcement. Posteriorly, the patient visited our clinic for epigastric pain and vomits. The proper study with gastroscopy, CT scan and barium swallow was ruled out, pointing a new relapse. With this results, the patient was purposed a redo cruroplasty with robotic approach. Results In the video we perform the crural robotic reinforcement with de use of biosynthetic absorbable mesh (Gore Bio-A) without any funduplication. This video aims to show the step-by-step in a redo hiatal surgery and the benefits of robotic surgery. In our short experience and according to the related publications we believe the robotic platform is feasible, safe and effective. Conclusion Although laparoscopic surgery to treat primary hiatal hernias (HHs) is the gold standard approach, the use of robotic platforms in complicated procedures such as relapsed hiatal hernias or gastroesophageal reflux disease (GERD) recurrence seems to gain weight. This is because of robotic approach may help in demanding surgeries with fibrosis and modified anatomy so it provides more precision with the articulating arms and better visualisation due to a 3D view and stable camera. Video https://drive.google.com/file/d/1BjwLWiEaNZWv6ULO9p-rec1LgSopfb1f/view?usp=sharing
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