HJBR Nov/Dec 2024

HEALTHCARE JOURNAL OF BATON ROUGE  I  NOV / DEC 2024 59 Mark G. Hausmann, MD Bariatric and General Surgeon Our Lady of the Lake Robotic Surgery Institute • Reduced conversion rates: In difficult cases, such as those with large hiatal hernias or dense adhesions from pre- vious surgeries, robotic surgery has been associated with lower conver- sion rates to open surgery compared to standard laparoscopy. • Shorter hospital stays: Patients un- dergoing robotic-assisted fundopli- cation often experience shorter hos- pital stays and quicker recovery times due to reduced postoperative pain and faster mobilization. • Less intraoperative blood loss: The meticulous control afforded by the robotic system leads to decreased in- traoperative blood loss, reducing the need for transfusions and associated risks. CLINICAL OUTCOMES Studies comparing robotic-assisted fundoplication to conventional laparo- scopic techniques have generally demon- strated equivalent outcomes in terms of symptom control and complication rates. Specific benefits of robotic-assisted sur- gery include: • Similar efficacy in controlling GERD symptoms. • Fewer perioperative complications, particularly in complex cases. • Faster recovery times and shorter hospital stays, contributing to higher patient satisfaction. Robotic-assisted surgery is a valuable tool in the surgical treatment of GERD, offering several advantages over tradition- al laparoscopic methods, particularly in complex cases. The potential for enhanced precision, shorter recovery times, and bet- ter overall outcomes make robotic surgery an attractive option for both patients and surgeons. As robotic systems continue to evolve and become more accessible, it is likely that their role in GERD treatment will ex- pand. Medical professionals involved in the care of GERD patients should remain informed about the capabilities and indi- cations of robotic surgery to offer the best treatment options for their patients. Successful treatment of GERD requires an understanding of the underlying dis- ease process and a comprehensive work- up with interdisciplinary collaboration between healthcare providers to ensure improved patients’ overall quality of life. n REFERENCES 1 Dallemagne, B.; et al. “Long-term results of lap- aroscopic fundoplication.” Surgical Endoscopy, 2016. 2 Schwaitzberg, S. D.; et al. “Robotic surgery: The revolution continues.” American Journal of Sur- gery, 2017 3 Peters, B. S., et al. “Robotic versus laparoscopic surgery for the treatment of GERD: Systematic review and meta-analysis.” Journal of Robotic Surgery, 2018 BrentW.Allain Jr., MD, is a bariatric and general sur- geonwith Our Lady of the Lake Robotic Surgery Insti- tute.Allain performs a wide variety of operations us- ingminimally invasive surgical techniques, including robotic surgery via the da Vinci surgical system. He has a special interest inweight loss surgery, including gastric sleeve, gastric bypass, gastric balloon, and revisional Bariatric surgery. His additional interests include surgery for gastroesophageal reflux (includ- ing the LINX procedure), gallbladder, hernia, colon, and surgery for hyperhidrosis. Mark G. Hausmann, MD, is a bariatric and general surgeon with Our Lady of the Lake Robotic Surgery Institute.Hausmann has special interest in advanced minimally invasive surgery including robotic surgery, particularly focusing on anti-reflux surgery and bariatric surgery, as well as surgery for benign and malignant colon diseases, hernia, gallbladder, and endocrine pathologies.He serves as a proctor to oth- er surgeons across the country, teaching advanced surgical techniques including robotic surgery with the daVinci surgical systemand the LINXprocedure for treatment of GERD. GERD, Nissen fundoplication, involves wrapping the gastric fundus around the lower esophagus to reinforce the lower esophageal sphincter (LES), preventing reflux. In a robotic-assisted procedure, the surgeon controls the robot to perform the fundoplication with heightened precision. The robotic approach allows for greater visualization and reach into the mediasti- num. Some of the benefits of the robotic plat- form include: • Access to complex anatomy: Patients with large hiatal hernias or those who have had previous abdominal surger- ies may present challenges that ro- botic surgery can better address. • Minimization of surgical trauma: Ro- botic arms enable more precise tissue handling, minimizing trauma to sur- rounding structures. • Improved suturing: The robotic plat- form allows for more intricate sutur- ing in tight spaces, crucial in creating a durable fundoplication wrap. Robotic systems are also used in the repair of hiatal hernias, often in combina- tion with fundoplication. By repairing the diaphragmatic defect, the esophagus can be restored to its natural position, comple- menting the reflux control achieved by the fundoplication. ADVANTAGES OF ROBOTIC SURGERY OVER TRADITIONAL TECHNIQUES Robotic surgery offers several advan- tages compared to traditional laparoscop- ic and open surgery: • Precision: The robotic platform al- lows for finer movements, leading to more accurate dissection, suturing, and tissue manipulation. This can be particularly useful in complex cases or in anatomically challenging areas.