Abstract
BackgroundThe treatment for sliding esophageal hernia with mild gastroesophageal reflux is usually conservative, but surgical treatment is recommended for refractory sliding esophageal hernia, paraesophageal hernia liable to prolapse, or paraesophageal hernia with ulceration and/or stenosis. Robotic surgery overcomes laparoscopic pitfalls by providing steady-state three-dimensional visualization, augmented dexterity with endo-wrist movements, and superior ergonomics for the surgeon.Case presentationTo investigate robotic paraesophageal hernia repair, a literature search was conducted using PubMed with the following key words: mini invasive surgery, robotic surgery, hiatal hernia, and Nissen fundoplication. We present the case of a 44-year-old Italian woman with a 20-year history of gastroesophageal reflux disease refractory to medical treatment, who underwent robotic Nissen fundoplication. In our center, we use the da Vinci® Xi™ Surgical System, which is an advanced tool for minimally invasive surgery.ConclusionsVarious reports published in the literature suggested that the robot-assisted approach was effective and was associated with very low postoperative morbidity and was accompanied by satisfactory symptomatic and anatomical radiological outcomes during a follow-up period.The robotic approach to paraesophageal repair is safe and effective with low complication rates. With increased experience, the operative time, length of stay, and complications decrease without compromising surgical principles.
Highlights
Hiatal hernia is defined as the temporary or permanent migration of a portion or all of the stomach, or other viscera, into the mediastinum via a defect in the diaphragmatic crura, which normally define the esophageal hiatus
Types 2 to 4 hiatal hernias are true paraesophageal hernias (PEHs) and are classified based on the location of the GEJ as well as what has herniated into the thoracic cavity
We present a case report of a 44-yearold woman with voluminous paraesophageal hiatal hernia treated with the robotic approach (Nissen fundoplication)
Summary
Hiatal hernia is defined as the temporary or permanent migration of a portion or all of the stomach, or other viscera, into the mediastinum via a defect in the diaphragmatic crura, which normally define the esophageal hiatus. This is a very common clinical problem, affecting up to 60% of the adult population [1]. Type 3, like type 2, has a portion of the stomach that has herniated through the hiatus, and has an abnormal position of the GEJ in the thoracic cavity. We use the da Vinci® XiTM Surgical System, which is an advanced tool for minimally invasive surgery
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