Observational studyLangenbeck's archives of surgery2025
A standardized robot-assisted technique for giant paraesophageal hernia repair: the relationship between surgical details and low recurrence rate in long-term follow-up.
Observational study in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
1 citing paper in PubMed.
- Robot-Assisted Antireflux Surgery in Gastro-Oesophageal Reflux Disease and Hiatal Hernia: Beyond Platform Comparison Towards Selective Clinical Value.The international journal of medical robotics + computer assisted surgery : MRCAS · 2026Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGiant Hiatal Hernia (GHH) is defined as a hiatal hernia that includes at least 30–50% of stomach in the chest. Laparoscopic approach may be challenging with high recurrence rates. Robotic surgery may overcome some laparoscopic limits, but its role is still debated.
methodsWe analysed a multicentric prospective database from 2011 to 2023 at General and Robotic Surgery Unit of San Giovanni Battista Hospital (Foligno-Spoleto, Italy) and General Surgery Unit of San Donato Hospital (Arezzo, Italy). A Robotic-Assisted Repair (RAR) was performed in all cases following a standardized surgical technique consisting of 6 steps. A literature review was carried out to identify surgical details linked to better outcomes.
results47 consecutive patients underwent RAR. Four procedures were performed in emergency setting and 2 were redo-surgery. 1 (2%) conversion to open was required. Mean operative time was 158 min (range 90–235), and mean length of stay was 2.9 days (range 2–7). Fundoplication was performed in 97% of cases, while cruroplasty using pladgets in the 100%. Bioabsorbable mesh was used in 95% of patients. Anterior gastropexy or gastrostomy was made in the 85%. No patients were readmitted within 30 days, while 3 (6%) showed radiologic recurrences without clinical symptoms at long-term follow-up.
conclusionsA standardized surgical technique in GHH repair achieves lower postoperative complications and recurrence rates even in a long-term follow-up. Robotic platforms allow for safer and technically easier procedures, also in emergency scenarios. Higher costs may be balanced by better postoperative outcomes when compared to conventional literature laparoscopic outcomes.
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