title: Robotic giant hiatal hernia repair: 3 year prospective evaluation and review of the literature.
abstract: BACKGROUND
  While conventional laparoscopic repair for giant hiatal hernias is considered difficult, robotic technology is likely to result in an improved postoperative course.
  
  
  METHODS
  We prospectively analysed patients with giant hiatal hernias who underwent robotic repair during a 3 year period. Preoperative data, operative variables, complications, clinical outcomes and anatomical recurrence after 1 year were evaluated.
  
  
  RESULTS
  Six patients with giant hiatal hernias underwent robotic repair using the Da Vinci surgical system. The mean operative time was 182 min. The mean hospital stay was 6 days. No patients required reoperation for disease recurrence, and all claimed the absence of postoperative symptoms.
  
  
  CONCLUSIONS
  Robotic approaches can minimize surgical trauma in patients with giant hiatal hernias and result in favourable outcomes in terms of anatomical recurrence and quality of life. With the availability of the da Vinci System, all patients with giant hiatal hernias can be offered a minimally invasive surgical option.
authors.affiliation: General Surgery unit, Department of Oncology, Transplantation and New Technologies, University of Pisa, Italy; EndoCAS (Centre for Computer Assisted Surgery), University of Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Morelli
authors.forename: Simone
authors.initials: S
authors.lastname: Guadagni
authors.forename: Maria Donatella
authors.initials: MD
authors.lastname: Mariniello
authors.forename: Roberta
authors.initials: R
authors.lastname: Pisano
authors.forename: Cristiano
authors.initials: C
authors.lastname: D'Isidoro
authors.forename: Mario Antonio
authors.initials: MA
authors.lastname: Belluomini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Caprili
authors.forename: Giulio
authors.initials: G
authors.lastname: Di Candio
authors.forename: Franco
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006551:Hernia, Hiatal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
keywords: da Vinci® system; hiatal hernia repair; minimally invasive procedure; robotic surgery