title: Early operative outcomes and learning curve of robotic assisted giant paraesophageal hernia repair.
abstract: BACKGROUND
  We have previously described our technique of robotic-assisted giant paraesophageal hernia repair (RA-GPEHR). The purpose of this study was to report our initial experience, early outcomes and learning curve with RA-GPEHR using a four-arm robotic platform.
  
  
  METHODS
  24 consecutive patients presenting with symptomatic giant paraesophageal hernias (GPEH) underwent RA-GPEHR from April 2011 to February 2014. Peri-operative data and short-term patient outcomes were assessed by retrospective review of a prospectively maintained database.
  
  
  RESULTS
  Median age was 62 years (range 44-84). 15 (63%) patients underwent fundoplication and 9 (37%) gastropexy. Median procedure time was 277 min (range: 185-485) and decreased steadily over the experience. There were no intra-operative complications or surgical mortality. No patients experienced dysphagia in the early post-operative period.
  
  
  CONCLUSIONS
  RA-GPEHR is safe, with reported short-term operative and functional outcomes similar to conventional laparoscopic approaches. The initial learning curve appears relatively short for experienced minimally invasive esophageal surgeons. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Inderpal S
authors.initials: IS
authors.lastname: Sarkaria
authors.affiliation: Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: M Jawad
authors.initials: MJ
authors.lastname: Latif
authors.affiliation: Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Valentino J
authors.initials: VJ
authors.lastname: Bianco
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Manjit S
authors.initials: MS
authors.lastname: Bains
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Valerie W
authors.initials: VW
authors.lastname: Rusch
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Jones
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Nabil P
authors.initials: NP
authors.lastname: Rizk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D004947:Esophagus / Q000601:surgery; D005260:Female; D018662:Fundoplication / Q000379:methods*; D006551:Hernia, Hiatal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D061214:Patient Safety; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000193:education* / Q000379:methods*; D019616:Thoracic Surgical Procedures / Q000193:education* / Q000379:methods*; D016896:Treatment Outcome
keywords: Robotic thoracic surgery; minimally invasive paraesophageal hernia repair; robotic assisted paraesophageal hernia repair