Robot-assisted laparoscopic repair in hiatal hernia with kyphosis: A case report with meta-analysis

BACKGROUND: Hiatal hernia is a high incidence disease, of which, partial patients requiring surgery have gastroesophageal reflux or dysphagia. Although minimally invasive surgery has been widely utilized in recent years, the optimal surgical therapy still remains controversial. In this study, we reported a kyphosis patient undergoing robot-assisted laparoscopic hiatal hernia repair and launched a meta-analysis aiming to evaluate the advantages of this surgery strategy. MATERIALS AND METHODS: Six databases (Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, EMBASE, ClincialTrials.gov database and Web of Science) were searched from inception to September 20, 2022. All studies describing the patients undergoing robotic hiatal hernia or laparoscopic hiatal hernia were included. And the meta-analysis was performed using R package meta (v6.0.0). RESULTS: We reported a 75-year-old female patient of short stature and with severe kyphosis was diagnosed with hiatal hernia and underwent a robotic surgery. For meta-analysis, 1,128 articles were identified in the initial database search, and among them, 6 articles were included in the final analysis. The results showed that robotic surgery had no advantage in operation time and intraoperative complications rate compared with traditional laparoscopic surgery (both P < 0.01). Regardless of the statistical significance, robotic surgery tended to have a lower conversion and postoperative complication rate, as well as the length of hospital stay. CONCLUSIONS: Robotics have some advantages in the surgical treatment of hiatal hernia compared with the conventional laparoscopic surgery, the use of which can facilitate the treatment for some challenging cases.