Surgical treatment of gastroesophageal reflux disease

A systematic review of available scientific publications on this topic from 2015 to 2025 was conducted. The surgical treatment of hiatal hernias, including giant paraesophageal hernias, remains a challenging task requiring high precision in anatomical restoration and minimization of intraoperative risks. Currently, the laparoscopic approach is considered the gold standard; however, the introduction of robotic systems (such as Da Vinci) has opened new possibilities due to improved visualization, increased instrument maneuverability, and enhanced ergonomics for the surgeon. RALF is a promising method for the surgical treatment of GERD, particularly in patients with refractory disease, obesity, and anatomical peculiarities (short esophagus). The technical advantages of the Da Vinci Si robotic system help reduce intraoperative complication risks and improve long-term functional outcomes. However, the high cost and the need for specialized surgeon training limit the widespread adoption of this technique.