Experience of robot-assisted anti-reflux surgical interventions for hernias of the esophageal hole using the Da Vinci Si and Versius robotic platforms

Relevance. At present, little experience has been accumulated in the world in the use of robotic surgical complexes in the treatment of GERD and hiatal hernia (HH), which made it relevant to include in this study the results of many years of experience in treating patients using the robot-assisted laparoscopic fundoplication (RALFN) to conduct a multivariate analysis of intraoperative and postoperative results and assess the objective perioperative status of patients, taking into account the dynamics of indicators that determine the quality of life in the late postoperative period. Materials and methods. A group of authors conducted a retrospective assessment of the results of clinical observations, as well as archival data of patients operated on clinical bases. The study included patients who underwent RALFN on the Da Vinci Si and Versius platform — 203 patients (100 %). Results. RALFN was performed in all patients. Intraoperative complications were detected in 13 (6.4 %) patients. The median duration of the operation was 120 (70-150) minutes; median intraoperative blood loss was 110 (50-300) ml. There were no intraoperative access conversions or deaths. Grade 3b postoperative complications according to the Clavien-Dindo scale — 3 (1.5 %) patients. Analysis of the quality of life of patients according to GERD-Q showed an average score of 3.9 12 months after surgery. For 2025, 6 clinical relapses were recorded. Discussion. RALFN provides a low percentage of postoperative complications, rapid disappearance of pain, optimal immediate and long-term results in patients. The results of this study demonstrate the undoubted safety and effectiveness of this technique.