Kuri OJA, Galeana NFI, Luján MKI, Solórzano AJJ, Aguirre GMP

Language: Spanish
References: 26
Page: 71-78
PDF size: 389.57 Kb.

ABSTRACT

Introduction: The minimally invasive approach to antireflux surgery begins with Dr. Dallemagne et al. in 1991. The evolution of minimally invasive surgery is currently at the cusp with the robot-assisted approach. The beginning of robotic surgery in antireflux surgery is described in 1999, only eight years after conventional laparoscopic surgery. Robot-assisted procedures in the upper gastrointestinal tract have increased, today this approach can be considered as a tool that improves the results of antireflux surgery. Material and methods: Retrospective analysis of all the records of patients who underwent robot-assisted fundoplication in the period from January 2016 to August 2020 by the same surgical team. Results: 100 cases of fundoplications were documented in the study period, the cases were divided into three groups: Primary fundoplications 66 (group A), re-fundoplications 28 (group B) and re-fundoplications with pyloroplasty 6 (group C). In group A, the average age was 66.3 years (21 to 79 years), 37 were women (56%) and 29 men (44%). The total surgical time averaged 93.2 minutes (60 to 120 minutes) with an average docking time of 8.5 minutes (6 to 14 minutes). Group B, the average age was 63.2 years (32 to 78 years), 17 were men (60%) and 11 women (40%). The total surgical time averaged 124.6 minutes (70 to 190 minutes) with an average docking time of nine minutes (7 to 16 minutes). Group C mean age was 52.7 years (33 to 63 years), four were men (66%) and 2 women (34%). Total surgical time averaged 172.1 minutes (120 to 210 minutes) with an average docking time of 10 minutes (7 to 18 minutes). Minor intraoperative complications in group A (1.5%), minor intraoperative complications in group B (3.5%). Reinterventions, only one case in group A, due to fundoplication migration at three months. Group C without complications. Discussion: The series presents a morbidity for REDO (re-fundoplication) of 3.5% compared to 2.6% that is documented in the international literature. The mean total surgical time was 93.2 minutes for primary fundoplication, maintaining surgical times even below the ranges documented in international series (88 to 137 minutes for primary fundoplication). Conclusion: The results today have demystified robotic surgery as an unattainable procedure in costs due to a reduction in morbidity and surgical times. Robotic Surgery in Mexico has results comparable to those of the international literature. More studies are required in Mexico to obtain greater statistical relevance.

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