Letter to the Editor on “Complications Following Robotic Hiatal Hernia Repair Are Higher Compared to Laparoscopy”

Author(s):  
Tanuja Damani ◽  
Michael Awad
2021 ◽  
Vol 9 (F) ◽  
pp. 186-188
Author(s):  
Danilo Coco ◽  
Silvana Leanza

To investigate, the results which contrasted robotic assisted hiatal hernia repair (RA-HHR) against laparoscopic hiatal hernia repair (LPHHR) we conducted a review. The results indicated feasibility and safety associated with the robotic method. The comparison of studies did not reveal variations in mortality and morbidity rate, conversion rate, ICU stay, 1-month mortality, and post-operative complications, quality of life between the RA-HHR cohort and LPHHR cohort.


Author(s):  
Joslin N. Cheverie ◽  
Ryan C. Broderick ◽  
Robert F. Cubas ◽  
Santiago Horgan

Author(s):  
Marc A. Ward ◽  
Salman S. Hasan ◽  
Christine E. Sanchez ◽  
Edward P. Whitfield ◽  
Gerald O. Ogola ◽  
...  

Author(s):  
Yalini Vigneswaran ◽  
Ava F. Bryan ◽  
Brian Ruhle ◽  
Lawrence J. Gottlieb ◽  
John Alverdy

Abstract Introduction Complex and recurrent paraesophageal hernia repairs are a challenge for surgeons due to their high recurrence rates despite the use of various prosthetic and suturing techniques. Methods Here we describe the use of vascularized fascia harvested from the posterior rectus sheath with peritoneum during robotic hiatal hernia repair in two patients with large complex diaphragmatic defects. Results Successful harvesting and onlay of the right posterior rectus sheath based on a falciform vascular pedicle was achieved robotically by rotating and securing the flap to the diaphragmatic hiatus as an onlay flap following cruroplasty of the hiatal defect. Conclusions In patients with difficult to repair large paraesophageal hernias, we demonstrate a promising new technique to restore the dynamic hiatal complex with the tensile strength of autologous vascularized fascia and peritoneum.


2018 ◽  
Author(s):  
Konstantinos Konstantinidis ◽  
Michael Konstantinidis ◽  
Savvas Hirides ◽  
Petros Hirides

2017 ◽  
Author(s):  
N Niclauss ◽  
MK Jung ◽  
V Belfontali ◽  
A Vogel ◽  
ME Hagen ◽  
...  

2020 ◽  
Vol 86 (9) ◽  
pp. 1083-1087
Author(s):  
Sean C. O’Connor ◽  
Matthew Mallard ◽  
Shivani S. Desai ◽  
Francisco Couto ◽  
Matthew Gottlieb ◽  
...  

Introduction Robotic hiatal hernia repair offers potential advantages over traditional laparoscopy, most notably enhanced visualization, improved ergonomics, and articulating instruments. The clinical outcomes, however, have not been adequately evaluated. We report outcomes of laparoscopic and robotic hiatal hernia repairs. Methods A retrospective observational cohort study was performed of all hiatal hernia repairs performed from 2006 through 2019. Operative, demographic, and outcomes data were compared between laparoscopic and robotic groups. Discrete variables were analyzed with Chi-square of Fisher’s exact test. Continuous variables were analyzed with Student’s t test (mean) or Wilcoxon rank sum (medians). All analyses were performed using R statistical software. Results Laparoscopic repair was performed in 278 patients and robotic repair in 114. More recurrent hernias were repaired robotically (24.5% vs 12.9%, P = .08). Operative times were no different between groups (175 vs 179 minutes; P = .681). Robotic repair resulted in significantly shorter length of stay (LOS; 2.3 vs 3.3 days; P = .003). Rate of readmission was no different, and there were no differences in acute complications. For patients with at least 1 year of follow-up, recurrence rates were lower after robotic repair (13.3% vs 32.8%; P = .008); however, mean follow-up is significantly longer after laparoscopic repair (23.7 ± 28.4 vs 15.1 ± 14.9 months; P < .001). Discussion Robotic hiatal hernia repair offers technical advantages over laparoscopic repair with similar clinical outcomes.


Hernia ◽  
2021 ◽  
Author(s):  
P. U. Oppelt ◽  
I. Askevold ◽  
R. Hörbelt ◽  
F. C. Roller ◽  
W. Padberg ◽  
...  

Abstract Purpose Trans-hiatal herniation after esophago-gastric surgery is a potentially severe complication due to the risk of bowel incarceration and cardiac or respiratory complaints. However, measures for prevention and treatment options are based on a single surgeon´s experiences and small case series in the literature. Methods Retrospective single-center analysis on patients who underwent surgical repair of trans-hiatal hernia following gastrectomy or esophagectomy from 01/2003 to 07/2020 regarding clinical symptoms, hernia characteristics, pre-operative imaging, hernia repair technique and perioperative outcome. Results Trans-hiatal hernia repair was performed in 9 patients following abdomino-thoracic esophagectomy (40.9%), in 8 patients following trans-hiatal esophagectomy (36.4%) and in 5 patients following conventional gastrectomy (22.7%). Gastrointestinal symptoms with bowel obstruction and pain were mostly prevalent (63.6 and 59.1%, respectively), two patients were asymptomatic. Transverse colon (54.5%) and small intestine (77.3%) most frequently prolapsed into the left chest after esophagectomy (88.2%) and into the dorsal mediastinum after gastrectomy (60.0%). Half of the patients had signs of incarceration in pre-operative imaging, 10 patients underwent emergency surgery. However, bowel resection was only necessary in one patient. Hernia repair was performed by suture cruroplasty without (n = 12) or with mesh reinforcement (n = 5) or tension-free mesh interposition (n = 5). Postoperative pleural complications were most frequently observed, especially in patients who underwent any kind of mesh repair. Three patients developed recurrency, of whom two underwent again surgical repair. Conclusion Trans-hiatal herniation after esophago-gastric surgery is rare but relevant. The role of surgical repair in asymptomatic patients is disputed. However, early hernia repair prevents patients from severe complications. Measures for prevention and adequate closure techniques are not yet defined.


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