TPT 8.02 Patient Outcomes After Robotic Hiatus Hernia Repair: A Single-High Volume UK Center Experience

Abstract

Hiatus hernias are frequently associated with significant reflux and other debilitating symptoms. Robotic hiatus hernia repair (RHHR) provides superior ergonomics and enhanced suturing dexterity, often translating into improved surgical outcomes, particularly with confined operative field of the oesophageal hiatus, compared to traditional laparoscopy techniques. This study aims to evaluate the postoperative and clinical outcomes of robotic giant hiatus hernia repair in adult patients. We retrospectively reviewed patients who underwent RHHR between February-2022 and November-2025. Symptom severity was assessed using 24-hour pH monitoring, and proton pump inhibitor (PPI) use. Primary outcomes assessed were recurrence and re-operation rates at follow up. Secondary outcomes assessed were peri-operative morbidity including, and complications (Clavien–Dindo). The study cohort included 34 patients (14 men and 20 women, median age 59 years, mean BMI 31.4 ± 3.9). The majority had type III (para-oesophageal) hernias, with a median symptom duration of 60 months and a mean DeMeester score of 54.9 ± 32.1. Twenty-four patients completed one-year follow-up during the study period. Reflux symptoms resolved in all patients; 21 discontinued PPI therapy, and all returned to a normal diet and routine activities within 8 weeks of surgery. Clavien–Dindo grade ≥2 complications occurred in four patients, including one requiring laparoscopic revision surgery. RHHR is a safe and effective approach, achieving symptom resolution and return to a normal diet, while offering the surgeon enhanced operative precision. Recurrence rates were low. This work is now being continued as a prospective study to evaluate long-term durability of outcomes.