SP 1.02 Four Years of Fundoplication: A Comparative Study of Robotic vs Laparoscopic Hiatal Surgery in a UK District General Hospital
Jada Saunders, Mustafa Alqasem, Edward J Nevins, Sadiq Bawa, Liam HorganAbstract
Aims
Robotic hiatal and anti-reflux surgery (ARS) is increasingly used in the UK, but outcome data from non-tertiary centres remain limited. This study compares robotic and laparoscopic anti-reflux surgery and assesses compliance with national and international perioperative standards.
Methods
All adult patients undergoing elective laparoscopic or robotic hiatal or ARS between February 2022 and January 2026 were retrospectively analysed. Patient demographics, operative metrics, peri-operative investigations, operative techniques, and outcomes were analysed.
Results
A total of 100 patients were included (57 robotic, 43 laparoscopic). Robotic procedures had significantly shorter median operative times (88 min [IQR 70–120] vs 120 min [IQR 90–144], p = 0.017) and higher day-case rates (63.2% vs 27.9%, p = 0.0006). Revisional surgery was more frequently performed robotically (33.3% vs 11.6%, p = 0.006), reflecting increased use of robotics for complex cases. Rates of postoperative complications, 30-day readmission, return to theatre, and hernia recurrence were low and comparable between approaches. Adherence to national investigation standards was variable: gastroscopy was performed in 82%, manometry in 53%, and pH testing in 54% of patients. When manometry or pH studies were not feasible, barium swallow was frequently employed as an alternative. All patients received post-operative dietary advice. Median follow-up was 3 months and PPI cessation achieved in 63% of patients post-operatively.
Conclusion
Robotic anti-reflux surgery is safe and effective in non-tertiary centres, with high day-case rates and outcomes comparable to laparoscopy. These findings support broader adoption of robotic platforms where appropriate infrastructure and expertise exist.