Robot-assisted versus conventional laparoscopic Nissen fundoplication - A comparative retrospective study on costs and time consumption

Background: Laparoscopic Nissen fundoplication offers clear benefits for our patients, but requires advanced laparoscopic skills. Robotic assistance in laparoscopic antireflux surgery improves dexterity skills and shortens learning curve, possibly leading to faster, more precise, and safer laparoscopic surgery. Methods: We review our first 11 cases of robot-assisted laparoscopic Nissen fundoplication using the 4-armed daVinci surgical system, comparing them with patients who underwent conventional laparoscopic Nissen fundoplication for gastroesophageal reflux disease in the same period. Results: Robot-assisted laparoscopic Nissen fundoplication did not result in more complications. However, the use of robotic assistance took an extra-47 minutes to complete the operation and costs were raised with an accessory euro987.47. Conclusions: The use of robotic assistance in laparoscopic antireflux surgery is safe and feasible, but results in longer operating time and higher costs compared with conventional laparoscopic surgery without proven benefit at this moment.