Nissen Fundoplication, Robotic-assisted Versus Laparoscopic Procedure: A Comparative Study in Children

Background/Purpose: Many reports have addressed the feasibility and safety of robotic-assisted surgery. However, few have compared the use of robots with the standard laparoscopic approach in various procedures. The aim of this study was to compare robotic-assisted Nissen fundoplication (RNF) with laparoscopic Nissen fundoplication (LNF). Methods: Children who underwent RNF were compared with those who underwent LNF during the same period at the same institution. Data collected included patient demographics, surgical indications, operative times, intraoperative and postoperative complications and clinical outcomes. Results: Between January 2005 and July 2008, 25 patients underwent RNF and 25 underwent LNF. Both groups were similar with regard to age, male/female ratio, and body weight. The total operative time was comparable in both groups. There were no deaths, intraoperative complications or untoward events. There were no significant differences in postoperative complication rates, postoperative analgesic requirements or lengths of hospital stay between the groups. Short-term clinical results with respect to gastroesophageal reflux symptoms were comparable in both groups after 14 months of follow-up. Conclusion: RNF is a safe and feasible alternative to LNF. There were no significant differences in outcomes measured between groups. In view of the high cost of robotic devices, no clear benefits of using robotics in Nissen fundoplication were observed.