Robin Schmitz, MD1, Dietmar Stephan, MD2, Justin Barr, MD, PhD1, Heike Saelzer, MD2, Michael Scheidt2, Joachim Labenz, MD2, Sabino Zani, MD1, Frank Willeke, MD2. 1Duke University Medical Center, Durham, NC, 2St. Marienkrankenhaus, Siegen, Germany
Purpose: Potential advantages of robotic assisted surgery are expected for intracorporal suturing, given its long learning curve in conventional laparoscopy. The success of laparoscopic fundoplication relies on precise suturing of the fundal wrap at the hiatus. Therefore robotic assistance could be a useful tool in this particular procedure.
Since February 2015 patients undergo anti-reflux surgery at our institution in an interdisciplinary setting. In March 2017, the Senhance® Surgical System (Transenterix Inc) was introduced in our clinical practiceand utilized in upper GI surgeries.
Methods: After team training and establishment of standard operating procedures in hernia repair, robotic assisted surgery at the gastro-esophageal junction was initiated. All patients gave informed consent for robotic assistance with prospective data acquisition and analysis. An independent investigator not involved in direct patient care performed the data analysis.
Results: Between March 2017 and January 2018, we performed a total of 22 antireflux surgeries with the Senhance® System. Ten patients underwent robotic assisted Nissen fundoplication. In two patients conversion to laparoscopic fundoplication was necessary. The cockpit time ranged from 62 to 172 minutes. The docking time (positioning of the robotic arms after initiation of the pneumoperitoneum) ranged between 4 and 14 minutes. We performed one re-laparoscopy on the day of surgery due to pain without any significant intraoperative findings and one laparoscopic revision to Toupet fundoplication after 7 months due to dysphagia.
Conclusion: This is the first reported experience with the Senhance® Surgical System in upper GI surgery. Robotic assisted Nissen fundoplication is technically feasible utilising this new robotic platform. Larger case series and randomised trials are needed to verify the value for upper GI-surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93203
Program Number: P707
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster