title: Robot-assisted versus conventional laparoscopic Nissen fundoplication: a comparative retrospective study on costs and time consumption.
abstract: BACKGROUND
  Laparoscopic Nissen fundoplication offers clear benefits for our patients, but requires advanced laparoscopic skills. Robotic assistance in laparoscopic antireflux surgery improves dexterity skills and shortens learning curve, possibly leading to faster, more precise, and safer laparoscopic surgery.
  
  
  METHODS
  We review our first 11 cases of robot-assisted laparoscopic Nissen fundoplication using the 4-armed daVinci surgical system, comparing them with patients who underwent conventional laparoscopic Nissen fundoplication for gastroesophageal reflux disease in the same period.
  
  
  RESULTS
  Robot-assisted laparoscopic Nissen fundoplication did not result in more complications. However, the use of robotic assistance took an extra-47 minutes to complete the operation and costs were raised with an accessory euro 987.47.
  
  
  CONCLUSIONS
  The use of robotic assistance in laparoscopic antireflux surgery is safe and feasible, but results in longer operating time and higher costs compared with conventional laparoscopic surgery without proven benefit at this moment.
authors.affiliation: Department of Surgery, Maastricht University Hospital, Maastricht, The Netherlands. Heemsch@hetnet.nl
authors.forename: Jeroen
authors.initials: J
authors.lastname: Heemskerk
authors.forename: Wim G
authors.initials: WG
authors.lastname: van Gemert
authors.forename: Jan Willem M
authors.initials: JW
authors.lastname: Greve
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Bouvy
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D005260:Female; D018662:Fundoplication / Q000191:economics* / Q000379:methods*; D017048:Health Care Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies; D012371:Robotics / Q000191:economics*