Volkan OTER, Erdal Birol BOSTANCI, Mehmet Ali BAL, Mehmet AZİRET, Kerem KARAMAN, Metin ERCAN

Robotic Surgery Versus Laparoscopic Nissen Fundoplication For Gastroesophageal Reflux Disease

INTRODUCTION: Laparoscopic Nissen fundoplication was the gold standard for gastroesophageal reflux disease but nowadays, robotic surgery is also safe and effective method too. No consensus currently exists regarding the use of robotic or laparoscopic surgery in. The aim of the present study was to compare standard laparoscopic NF with the robotic NF approach in terms of the advantages and disadvantages of using each procedure. METHODS: A patient group of 42 candidates for Nissen fundoplication. Of these, 28 were treated by traditional laparoscopy (Group I) and 14 by robotic surgery (Group II). The synchronization was provided in the two groups about age, gender and body mass index. RESULTS: All patients underwent Hiatus hernioplasty and Nissen fundoplication. There were no conversions to open procedures and no in-hospital deaths. Mean operation time was 127.46± 42.04 minutes in group I and 253.57±42.48 minutes in group II. There were statistically significant differences in this parameter from groups I and II (p

Gastroözefageal Reflü Hastalığında Robotik Fundoplikasyona Karşı Laparoskopik Nissen Fundoplikasyonu

GİRİŞ ve AMAÇ: Laparoskopik Nissen fundoplikasyonu gastroözofageal reflü hastalığı için altın standarttır, ancak günümüzde robotik cerrahi de güvenli ve etkili bir yöntemdir. Ülkemizde robotik veya laparoskopik cerrahi kullanımı ile ilgili henüz bir fikir birliği yoktur. Bu çalışmanın amacı, standart laparoskopik NF'yi, robotik NF yaklaşımıyla, prosedürleri kullanmanın avantajları ve dezavantajları açısından karşılaştırmaktır. YÖNTEM ve GEREÇLER: Nissen fundoplikasyonu yapılan toplam 42 hasta çalışmaya dahil edildi. Bunlardan 28' i geleneksel laparoskopi (Grup I) ve 14'ü robotik cerrahi (Grup II) ile tedavi edildi. İki grupta yaş, cinsiyet ve vücut kitle indeksi ile ilgili senkronizasyon sağlandı. BULGULAR: Tüm hastalara hiatus henioplastisi ve Nissen fundoplikasyonu uygulandı. Ameliyat sırasında açık ameliyata geçilmedi ve sonrası mortalite gözlenmedi. Ortalama ameliyat süresi grup I'de 127.46 ± 42.04 dakika ve grup II'de 253.57 ± 42.48 dakika idi. Bu parametrede I ve II gruplarından istatistiksel olarak anlamlı fark vardı (p

PDF

___

1. Darling G, Deschamps C. Technical controversies in fundoplication surgery. Thorac Surg Clin 2005; 15: 437–444.

2. Mizuno M, Kobayashi M, Sasaki A, Nakajima J, Wakabayashi G. Early experience with single-incision laparoscopic Nissen fundoplication for gastroesophageal reflux disease in patients with mental retardation via a gastrostomy site incision: report of five cases. Surg Today 2012; 42: 601–4.

3. Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R. Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc 1991; 1: 138–143.

4. Wykypiel H, Bodner J, Wetscher G, Schmid T. Robot-assisted versus conventional laparoscopic fundoplication: short-term outcome of a pilot randomized controlled study. Surg Endosc 2008; 22: 1407.

5. Müller-Stich BP, Reiter MA, Wente MN, Bintintan VV, Köninger J, Büchler MW et al. Robot-assisted versus conventional laparoscopic fundoplication: short-term outcome of a pilot randomized controlled trial. Surg Endosc 2007; 21: 1800–1805.

6. Morino M, Pellegrino L, Giaccone C, Garrone C, Rebecchi F. Randomized clinical trial of robot-assisted versus laparoscopic Nissen fundoplication. Br J Surg 2006; 93: 553–558.

7. Draaisma WA, Ruurda JP, Scheffer RC, Simmermacher RK, Gooszen HG, Rijnhart-de Jong HG et al. Randomized clinical trial of standard laparoscopic versus robot-assisted laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease. Br J Surg 2006; 93: 1351–1359.

8. Cadière GB, Himpens J, Ertruyen M, Bruyns J, Germay O, Leman G et al. Evaluation of telesurgical (robotic) NISSEN fundoplication. Surg Endosc 2001; 15: 918–923.

9. Nakadi IE, Mélot C, Closset J, DeMoor V, Bétroune K, Feron P et al. Evaluation of da Vinci Nissen fundoplication clinical results and cost minimization. World J Surg 2006; 30: 1050–1054.

10. Melvin WS, Needleman BJ, Krause KR, Schneider C, Ellison EC. Computer-enhanced versus standard laparoscopic antireflux surgery. J. Gastrointest. Surg. 2002; 6: 11–5.

11. Prasad SM, Ducko CT, Stephenson ER, Chambers CE, Damiano RJ Jr. Prospective clinical trial of robotically assisted endoscopic coronary grafting with 1-year follow-up. Ann. Surg. 2001; 233: 725–32.

12. Morino M, Pellegrino L, Giaccone C, Garrone C, Rebecchi F. Randomized clinical trial of robot-assisted versus laparoscopic Nissen fundoplication. Br. J. Surg. 2006; 93: 553–8.

13. Muller-Stich BP, Reiter MA, Wente MN, Bintintan VV, Köninger J, Büchler MW et al. Robot-assisted versus conventional laparoscopic fundoplication: short-term outcome of a pilot randomized controlled trial. Surg. Endosc. 2007; 21: 1800–5.

14. Jun M, Yingxin K, Xiao C, Wang B, Wang Z. Whether robot-assisted laparoscopic fundoplication is better for gastroesophageal reflux disease in adults: a systematic review and meta-analysis. Surg Endosc 2010; 24: 1803–1814.

15. Markar SR, Karthikesalingam AP, Hagen ME, Talamini M, Horgan S, Wagner OJ. Robotic vs. laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease: systematic review and meta-analysis. Int J Med Robot. 2010; 6: 125-31.

16. Owen B, Simorov A, Siref A, Shostrom V, Oleynikov D. How does robotic anti-reflux surgery compare with traditional open and laparoscopic techniques: a cost and outcomes analysis. Surg Endosc. 2014; 28: 1686-90.