Our Summary

This research paper is about a common disease called gastroesophageal reflux disease (GERD), which is when stomach acid gets into the esophagus (the tube that connects your throat to your stomach). This can cause a lot of discomfort and pain. Surgery is usually recommended when tests have confirmed the presence of this disease. The preferred surgical treatment is called laparoscopic Toupet fundoplication.

The researchers in this paper found that using a robot to assist in the initial surgery didn’t really have any clear benefits. However, they did find it helpful to use a robot for repeat surgeries or for repairing larger issues in the area where the esophagus and stomach meet. In simpler terms, the robot wasn’t very useful for the first surgery, but it was handy for fixing bigger problems or doing the surgery again if needed.

FAQs

  1. What is the preferred treatment for Gastroesophageal reflux disease (GERD)?
  2. Does robotic assistance provide any clear advantages in primary antireflux surgery?
  3. When is the use of a robot found to be of added value in hiatal hernia repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair is to follow post-operative care instructions carefully, including avoiding heavy lifting, following a specific diet, and taking prescribed medications as directed. It is also important to attend follow-up appointments with your healthcare provider to monitor your recovery progress and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended hiatal hernia repair are those with gastroesophageal reflux disease (GERD) that is objectively documented, and who have not responded to conservative treatments such as medication or lifestyle changes. Surgery is indicated when the disease is causing significant symptoms or complications such as esophagitis, Barrett’s esophagus, or strictures. Laparoscopic Toupet fundoplication is the preferred treatment for GERD, and robotic assistance may be beneficial for redo surgery or large and giant hiatal repairs.

Timeline

Before hiatal hernia repair:

  1. Patient experiences symptoms of gastroesophageal reflux disease (GERD) such as heartburn, regurgitation, chest pain, and difficulty swallowing.
  2. Diagnostic tests such as endoscopy, pH monitoring, and imaging studies are performed to confirm the presence of a hiatal hernia and assess the severity of GERD.
  3. Treatment with medication, lifestyle changes, and dietary modifications may be prescribed to manage symptoms, but surgery is considered when conservative treatments are not effective.

After hiatal hernia repair:

  1. The patient undergoes laparoscopic Toupet fundoplication surgery to repair the hiatal hernia and prevent gastric acid from entering the esophagus.
  2. Recovery from surgery typically involves a hospital stay of 1-2 days and a period of restricted diet and activity.
  3. Follow-up appointments with the surgeon are scheduled to monitor healing, assess symptom improvement, and make any necessary adjustments to the treatment plan.
  4. Over time, the patient should experience a reduction in GERD symptoms and improved quality of life.

What to Ask Your Doctor

  1. What is a hiatal hernia and how does it affect my digestive system?
  2. What are the potential risks and benefits of undergoing a hiatal hernia repair surgery?
  3. Is laparoscopic Toupet fundoplication the best treatment option for my hiatal hernia?
  4. Are there any alternative treatments or non-surgical options for managing my hiatal hernia?
  5. How long is the recovery period after hiatal hernia repair surgery and what can I expect during the recovery process?
  6. What is the success rate of hiatal hernia repair surgery and how likely is it to relieve my symptoms?
  7. Are there any long-term effects or complications associated with hiatal hernia repair surgery?
  8. Will I need to make any lifestyle changes or follow a specific diet after the surgery to prevent recurrence of the hiatal hernia?
  9. How experienced are you in performing hiatal hernia repair surgeries and what is your success rate?
  10. Are there any specific criteria or tests that need to be met before proceeding with hiatal hernia repair surgery?

Reference

Authors: Tolboom RC, Broeders IA, Draaisma WA. Journal: J Surg Oncol. 2015 Sep;112(3):266-70. doi: 10.1002/jso.23912. Epub 2015 May 21. PMID: 25997926