Robotic hiatus hernia surgery : learning curve and lessons learned
Garsot Savall, Elisenda (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Company-Se, Georgina (Universitat Politècnica de Catalunya. Departament d'Enginyeria Electrònica)
Clavell, Arantxa (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Viciano, Marta (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Herrero Vicente, Christian J (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Nescolarde, Lexa (Universitat Politècnica de Catalunya. Departament d'Enginyeria Electrònica)
Universitat Autònoma de Barcelona. Departament de Cirurgia

Date:	2025
Abstract:	New procedures like the robotic approach require proficiency to ensure patient safety and satisfactory functional results. Hiatal hernia surgery serves as a suitable training procedure for upper gastrointestinal tract surgeons transitioning to the robotic approach. This study aims to evaluate the outcomes of implementing the robotic approach in hiatal hernia surgery at a tertiary hospital and to assess the associated learning curve. A retrospective review was conducted on 54 patients (58 surgeries) between June 2019 and March 2024, including both primary and revision robotic antireflux surgeries. The study focused on perioperative outcomes, symptom resolution, and the surgical learning curve, assessed using Cumulative Sum analysis. The results showed that global surgical time averaged 124 ± 57 (54-350) min, 127 ± 38 (116-139) for Primary Surgery and 164 ± 84 (115-212) min for Revisional Surgery. There were no conversions to laparoscopic or open approach. The global median of hospital stay was 2 days (2 for Primary Surgery and 3 for Revisional Surgery) and three patients required readmission (2 for Primary Surgery and 1 for Revisional Surgery). Postoperative complications occurred in 3 patients. Symptom resolution was achieved in 90% of Primary Surgery group and 85. 7% of Revisional Surgery group. Learning curve described three phases: 1-training (case 1 to 14), 2-plateau (15 to 25) and 3-expertise phase (25 onwards). The robotic approach in hiatal hernia surgery is feasible with minimal morbidity, short hospital stays, and excellent functional results. With previous experience in laparoscopic approach and esophagogastric surgery the learning curve can be reduced to 14 procedures.
Note:	Altres ajuts: acords transformatius de la UAB
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Hiatal hernia ; Robotic surgery ; Revisional surgery ; Learning curve
Published in:	Journal of robotic surgery, Vol. 19, Num. 51 (January 2025) , ISSN 1863-2491

DOI: 10.1007/s11701-024-02191-3
PMID: 39821364

8 p, 714.2 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles