Robotic-assisted versus laparoscopic Nissen fundoplication in the treatment of gastroesophageal refux disease: a comparative analysis of surgical advantages and short-term outcomes
10.3760/cma.j.cn113855-20250303-00115
- VernacularTitle:完全机器人Nissen胃底折叠术对比腹腔镜手术治疗胃食管反流病的优势及术后短期效果分析
- Author:
Ziwen WEI
1
;
Xiaoyu LIU
;
Chunli ZOU
;
Rujuan WANG
;
Yongyi XIE
;
Dingwei LU
;
Honglin YI
;
Yuewen ZHANG
;
Ruhong LI
;
Peng LI
Author Information
1. 昆明医科大学附属延安医院普通外科二科，昆明 650051
- Publication Type:Journal Article
- Keywords:
Gastroesophageal reflux;
Fundoplication;
Robot;
Hernia, hiatal;
Laparoscopies
- From:
Chinese Journal of General Surgery
2025;40(6):439-444
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the advantages and short-term clinical effects of totally robotic Nissen 360° fundoplication compared with laparoscopic surgery.Methods:A retrospective analysis was conducted on data of 110 patients undergoing Nissen 360° fundoplication at the Second Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University from Aug 2023 to Aug 2024. Among them, 50 cases underwent totally robotic fundoplication, and 60 cases underwent laparoscopic fundoplication. By comparing and analyzing the fatigue level of the primary surgeon during the operations, postoperative incisional pain in patients, swallowing function recovery and the time to resume a normal solid-food diet within 3 months post-surgery, the advantages of totally robotic surgery were evaluated. Additionally, by examining the postoperative recovery of reflux symptoms, postoperative patient comfort, and satisfaction levels in both groups, the short-term clinical outcomes of totally robotic surgery were assessed.Results:Both groups of patients successfully completed the surgeries without any intraoperative or postoperative complications occurring. The fatigue score of the primary surgeon in the totally robotic group was significantly better than that in the laparoscopic group[ (2.34±1.38) vs. (2.89±1.51), t=1.385, P<0.01]. The time taken to resume a normal solid-food diet postoperatively in the totally robotic group was significantly shorter than that in the laparoscopic group[ (27.90±6.77) d vs. (40.78±13.60) d, t =5.765, P<0.01]. Moreover, the postoperative pain comfort level was better in the robotic group than in the laparoscopic group [(1.65±0.72) points vs. (2.23±0.59) points, t=3.742, P<0.01]. Within 12 months postoperatively, the GERD-Q scores in the totally robotic group decreased significantly, and reflux symptoms disappeared, comparable to that in the laparoscopic group. Conclusions:The totally robotic Nissen 360° fundoplication leads to lower fatigue levels for the surgeon. Patients experience significant advantages in terms of postoperative pain perception and dietary recovery. Additionally, it demonstrates excellent postoperative anti-reflux efficacy, high patient comfort, and the surgery is safe and reliable.
