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International Society For Minimally Invasive Cardiothoracic Surgery

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Robotic Hiatal Hernia Repair And Mechanical Sphincter Augmentation
Farhan Nadeem, Abbas Abbas, Charles Bakhos, Roman Petrov, Shawn Robinson, Shrey Patel
Temple University Hospital, Philadelphia, PA, USA

BACKGROUND - Lower Esophageal Sphincter augmentation using interlinked titanium beads with magnetic cores (LINX device) is an alternative to fundoplication that is frequently performed for Gastroesophageal Reflux Disease (GERD). LINX implantation is most commonly performed by minimally invasive techniques. Complex hiatal hernia repairs, which are still most commonly performed using traditional open approaches can be supplemented with LINX procedure. This provides a unique opportunity to use the da Vinci system for its precision and degree of freedom.
METHODS - A 48 year old Female with 20 year history of GERD accompanied with chronic cough and hiatal hernia is presented. She had already failed medical management consisting of acid suppression therapy. She was offered repair of hiatal hernia and magnetic sphincter augmentation.
RESULTS - Technical aspects of the procedure are illustrated in the video.
CONCLUSIONS - A minimally invasive approach as part of combined hiatal hernia repair and magnetic sphincter augmentation is technically feasible to be performed using robotic platform. The distal articulated instrumentation of da Vinci Robot facilitated the procedure in technically challenging workspace.


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