Our Summary

This research paper looks at the financial and patient outcome differences between two types of hiatal hernia repair surgery - one using a robot and one done by a surgeon alone (laparoscopic). The researchers hypothesized that using a robot would cost more but have similar patient outcomes.

They looked at data from 73 patients who had one of the two surgeries at a single hospital from July 2020 to May 2021. They compared things like how long the patient stayed in the hospital, how long the surgery took, the cost of the surgery and supplies, and how much profit the hospital made.

The findings showed that there was no significant difference in how long patients stayed in the hospital or how long the surgery took between the two methods. However, the robot-assisted surgery did cost more in terms of supplies and charges to the patient. Despite this, the profit the hospital made was not significantly different between the two types of surgery.

In conclusion, even though robot-assisted surgery costs more, the hospital still made a similar profit and the patient outcomes were the same. The researchers suggest that hospitals should analyze their own costs to understand whether robot-assisted surgery would be beneficial for them.

FAQs

  1. Is there a difference in patient outcomes between robot-assisted and laparoscopic hiatal hernia repair surgeries?
  2. Does robot-assisted hiatal hernia repair surgery cost more than the traditional laparoscopic method?
  3. Did the hospital make more profit from robot-assisted surgeries compared to the traditional laparoscopic surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair is to discuss with their healthcare provider the different surgical options available, such as laparoscopic surgery or robot-assisted surgery. They should consider factors like cost, recovery time, and potential benefits of each option before making a decision. It’s important for patients to be informed and actively involved in their treatment plan.

Suitable For

Typically, patients who are recommended for hiatal hernia repair are those who experience symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and abdominal pain. These symptoms may be caused by the hiatal hernia allowing stomach acid to flow back into the esophagus, leading to gastroesophageal reflux disease (GERD).

Patients with larger hiatal hernias, especially those that are causing severe symptoms or complications such as Barrett’s esophagus or esophageal strictures, are more likely to be recommended for surgery. Additionally, patients who do not respond well to medications or lifestyle changes for managing their symptoms may also be candidates for hiatal hernia repair.

Ultimately, the decision to recommend hiatal hernia repair surgery is made on a case-by-case basis by the patient’s healthcare provider after considering the severity of symptoms, impact on quality of life, and potential risks and benefits of surgery.

Timeline

Before hiatal hernia repair:

  1. Patient experiences symptoms of hiatal hernia such as heartburn, chest pain, difficulty swallowing, regurgitation, and feeling full after eating.
  2. Patient undergoes diagnostic tests such as endoscopy, barium swallow, and pH monitoring to confirm the presence of a hiatal hernia.
  3. Patient discusses treatment options with their healthcare provider, including lifestyle changes, medications, and surgery.
  4. Patient decides to undergo surgery for hiatal hernia repair.

After hiatal hernia repair:

  1. Patient undergoes preoperative evaluation and preparation for surgery.
  2. Patient undergoes hiatal hernia repair surgery, either robot-assisted or laparoscopic.
  3. Patient stays in the hospital for a certain period of time for postoperative care and monitoring.
  4. Patient follows postoperative instructions for recovery, including diet modifications and activity restrictions.
  5. Patient attends follow-up appointments with their healthcare provider to monitor their progress and address any concerns.

What to Ask Your Doctor

Questions a patient should ask their doctor about hiatal hernia repair:

  1. What are the different options for hiatal hernia repair, including robot-assisted surgery and laparoscopic surgery?
  2. What are the potential risks and benefits of each type of surgery?
  3. How long will the surgery take and how long will I need to stay in the hospital for recovery?
  4. What is the cost difference between robot-assisted surgery and laparoscopic surgery, and how will it impact me financially?
  5. What is the expected outcome and success rate for each type of surgery?
  6. Will there be any long-term effects or complications to consider with either type of surgery?
  7. How experienced is the surgical team in performing each type of surgery?
  8. Are there any specific factors about my individual health or condition that would make one type of surgery more suitable for me?
  9. How will the recovery process differ between robot-assisted surgery and laparoscopic surgery?
  10. Are there any additional resources or support available to help me make an informed decision about which type of surgery to choose?

Reference

Authors: Lekarczyk A, Sinha H, Dvir D, Goyert J, Airhart A, Reddy RM. Journal: Surg Endosc. 2023 May;37(5):3952-3955. doi: 10.1007/s00464-022-09513-2. Epub 2022 Aug 23. PMID: 35999312