BACKGROUND

Gastroesophageal reflux disease is a common disease in children that leads to malnutrition and damage to the respiratory system. Nissen fundoplication is the treatment of choice for this disease. Surgical approaches to implement this principle include open, laparoscopic and robotic approaches. This article describes the first experience of performing a robot-assisted fundoplication in a child using the new generation robotic platform.

MATERIAL AND METHODS

Data are presented regarding a male patient aged 5 years, weighing 19.2 kg, operated on for gastroesophageal reflux using a robot-assisted approach. The diagnosis was confirmed by contrast X-ray examination of the esophagus and endoscopy of the upper gastrointestinal tract. Robot-assisted Nissen fundoplication was performed using the Versius surgical robot manufactured by «CMR Surgical» (UK).

RESULTS

Robot-assisted Nissen fundoplication is performed in a completely minimally invasive manner without conversion to an open procedure. The total duration of the operation was 105 minutes. Of these, 20 minutes were spent on installing the robot. The net time of the robotic procedure, excluding robot installation, reached 85 minutes. The operation was not accompanied by intraoperative complications, such as bleeding, perforation of the stomach and esophagus, or injury to adjacent anatomical structures. The duration of observation of the patient was 6 months. In the long-term period after the operations, no clinically significant complications were noted in the form of recurrence of symptoms of gastroesophageal reflux or narrowing of the esophagus.

CONCLUSION

Robotic fundoplication is an acceptable method for performing minimally invasive antireflux surgery in children. Our study shows that Nissen’s robotic-assisted fundoplication is feasible, safe, and as effective as laparoscopy.