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Early experience with robotic-assisted minimally invasive Collis gastroplasy
Nicholas Hess, BS1, Inderpal Sarkaria, MD2, Jonathan D'Cunha, MD2, Katie Nason, MD2, James Luketich, MD1.
1University of Pittsburgh School of Medicine, Pittsburgh, PA, USA, 2University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

OBJECTIVE: Collis gastroplasty is often necessary to obtain adequate, tension-free subdiaphragmatic esophageal length during gastrofundoplication. We wanted to report our early experience with a robotic-assisted approach to these procedures.
METHODS: This study was a retrospective review of patients undergoing Collis gastroplasty via a robotic-assisted minimally invasive approach.
RESULTS: From June 2014 to December 2015, a total of 29 sequential patients underwent robotic-assisted minimally invasive repair of hiatal hernia with or without gastrofundoplication. Of the 18 patients undergoing fundoplication, 10 received Collis gastroplasty. Patient demographics and selected perioperative outcomes for these procedures are reported in Table 1. Median operative time, estimated blood loss and hospital length of stay were within reported norms. There were no open conversions or postoperative leaks observed.
CONCLUSIONS: Our early institutional experience suggests Collis gastroplasty can be safely utilized. While robotic assistance, including the use of improved stapler technologies, may potentially improve the conduct of operation in these procedures, this needs to be evaluated in a larger series of patients.
Patient demographics and preoperative outcomes
Type 1 hernia; no. (%)5 (50%)
Type 2 hernia; no. (%)0 (0%)
Type 3 hernia; no. (%)4 (10%)
Type 4 hernia; no. (%)1 (10%)
Age; median (IQR), years70 (67-74)
Operating time; median (IQR), min354 (222-417)
Estimated blood loss; median (IQR), mL30 (20-50)
Hospital LOS; median (IQR), days5 (4-6)
Conversions; no. (%)0 (0%)
Postoperative leak; no. (%)0 (0%)


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