Objectives: The application of the robotic system for anti-reflux operations is ever expanding with innovation in surgical treatment.
Methods: This video is of a 79-year-old woman who presented to our clinic with a history of GERD. Preoperative workup included CT/EGD which showed a very large paraesophageal hiatal hernia. UGI was undertaken and resulted in two ‘stripping’ waves for liquid and solid bolus. The patient was entered into ERAS protocol and was scheduled to undergo a robotic hiatal hernia repair with Toupet fundoplication.
Results: The gastrohepatic ligament was dissected. Dissection was continued into the mediastinum. Once the stomach was reduced, the esophageal hiatus was repaired. A bougie was advanced and a new fundoplication was reconstructed. The stomach was then anchored to the right and left crus to prevent twisting, tension, or undoing of the fundoplication.
Conclusion: The patient tolerated the procedure well. JP drain was removed on the day of discharge on postoperative day 1. This video depicts the efficacy and safety of anti-reflux operations undertaken utilizing the robotic platform.
