OA10.4. Clinical Outcomes in Patients Undergoing Transoral Incisionless Fundoplication Versus Robotic Fundoplication for Gastroesophageal Reflux Disease Associated With Small Hiatal hernias
Abstract
Benign Disease: Gastro-Esophageal Reflux and Hiatal Hernia
Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder that often results from altered gastroesophageal junction anatomy and can result in high symptom burdens for patients. While traditional fundoplication is the gold-standard surgical intervention, transoral incisionless fundoplication (TIF) has emerged as a minimally invasive endoscopic alternative. This study aimed to compare the short- and mid-term outcomes of TIF versus robotic hiatal hernia repair (RoboHH) in patients eligible for TIF.
A retrospective cohort study analyzed 76 patients with pH-confirmed GERD and hiatal hernias less than 2 cm. Preoperative assessments included manometry, pH study, esophagram, and endoscopy. Postoperative follow-up at 3 and 12 months included clinical assessment and esophagram. Statistical analysis compared demographic, preoperative, perioperative, and clinical outcomes, including symptomatic improvement, recurrence, and reintervention rates.
48 patients underwent TIF and 27 underwent RoboHH. Baseline patient characteristics and preoperative hiatal hernia sizes were comparable between TIF and RoboHH groups. Operative time was significantly shorter for TIF (67 vs. 128 minutes, p<0.001), and TIF was associated with a lower rate of postoperative admission (13% vs. 100%, p<0.001). At 3 months, symptomatic improvement was similar (80% TIF vs. 85% RoboHH, p=0.078). However, by 1 year, RoboHH demonstrated…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 76 participants or records.
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