Robotic Approach to Paraesophageal Hernia Repair Results in Low Long-Term Recurrence Rate and Beneficial Patient-Centered Outcomes

Background Little is known regarding important long-term outcomes following robotic paraesophageal hernia (PEH) repairs, such as symptom relief and recurrence rates. The aim of this study was to evaluate the long-term clinical outcomes in a large series of patients undergoing robotic PEH repair. Methods This prospective, IRB-approved study analyzed adult patients who underwent robotic PEH repair from 2010 to 2014 at a high-volume tertiary academic medical center. Detailed information on patient characteristics, perioperative factors, and long-term patient reported outcomes for up to 5-years post-operatively were collected. Objective long-term outcomes included radiographic evidence of PEH recurrence at 1, 3, and 5-years post-operatively. Results A total of 233 patients underwent robotic PEH repair during the study period – 70% were primary, while 30% were revisional. Seventy-eight percent of patients (181) had a type III PEH, 21% (49) had a type IV, and 1% ( 3 ) had a type II. At 5-years post-operatively, 62% (145/233) of patients were available for follow-up with a radiographic recurrence rate of 9% (13/145). Additionally, there was a significant improvement in the GERD-HRQL score at 5-years post-operatively (pre-operative: 25.6 ± 8.7, 5-year post-operative, 4.5 ± 1.7, p Conclusion This study represents one of the largest longitudinal robotic foregut surgical databases to date. Our results demonstrate that robotic PEH repair with an experienced surgical team is a safe and effective alternative to laparoscopic repair with excellent long-term outcomes including a very low recurrence rate.