423. ROBOTIC SURGERY FOR BENIGN ESOPHAGEAL DISEASE: PROMOSING OUTCOMES OF AN EARLY CASE SERIES

Abstract Background Laparoscopic surgery is a well-established approach in the treatment of benign gastroesophageal junction (GEJ) disease. Robotic platforms have only recently been incorporated in surgery for esophageal motility disorders and their exact value remains to be determined. In the present study, we present our initial experience through a case series of patients with benign GEJ disease treated using the DaVinciXi robotic system in our department. Methods Patients undergoing surgery for benign GEJ disease during the last 5 years (01/2029-12/2023) were prospectively collected. Data regarding their perioperative and postoperative course was evaluated. All patients attended regular follow-up appointments. Patients with relapse or deterioration of their symptoms were referred for objective testing using high-resolution manometry or 24-h impedance pHmetry. Results 12 patients with achalasia were subjected to robotic Heller myotomy and modified Dor fundoplication, 13 patients underwent hiatal hernia repair and 2 patients underwent Nissen fundoplication due to severe reflux. Median operative time was 110min (96-150) and no intraoperative or postoperative complications were observed. All patients demonstrated resolution of their symptoms, with a median postoperative Eckardt score of 2 for patients with achalasia and median GERD score of 1 for patients with GERD. 2 patients with achalasia were subjected to impedance manometry due to temporary symptom relapse, without any abnormal findings. Conclusion The incorporation of robotic platforms in the treatment of achalasia, reflux and hiatal repair is safe with excellent perioperative and postoperative functional results, when performed in a high-volume center. Further experience will demonstrate potential advantages and disadvantages of the method and will allow for reliable comparison to the laparoscopic approach.