Robotic-Assisted Nissen Fundoplication in Pediatric Patients: A Matched Cohort Study

Rianne E M Killaars; Omar Mollema; Hamit Cakir; Ruben G J Visschers; Wim G van Gemert

doi:10.3390/children11010112

Robotic-Assisted Nissen Fundoplication in Pediatric Patients: A Matched Cohort Study

Children (Basel). 2024 Jan 17;11(1):112. doi: 10.3390/children11010112.

Authors

Rianne E M Killaars^{1

2

3}, Omar Mollema⁴, Hamit Cakir^{1

2}, Ruben G J Visschers^{1

2}, Wim G van Gemert^{1

2

3}

Affiliations

¹ Department of Pediatric Surgery, MosaKids Children's Hospital, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
² European Consortium of Pediatric Surgery (MUMC+, Uniklinik Aachen, Centre Hospitalier Chrétien Liège), Maastricht, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
³ Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, 6229 ER Maastricht, The Netherlands.
⁴ Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands.

Abstract

Background: Nissen Fundoplication (NF) is a frequently performed procedure in children. Robotic-assisted Nissen Fundoplication (RNF), with the utilization of the Senhance^® Surgical System (SSS^®) (Asensus Surgical^® Inc., Durham, NC, USA) featuring 3 mm instruments, aims to improve precision and safety in pediatric surgery. This matched cohort study assesses the safety and feasibility of RNF in children using the SSS^®, comparing it with Laparoscopic Nissen Fundoplication (LNF).

Methods and results: Twenty children underwent RNF with the SSS^® between 2020 to 2023 and were 1:1 matched with twenty LNF cases retrospectively selected from 2014 to 2023. Both groups were similar regarding male/female ratio, age, and weight. Two of the twenty RNF cases (10%) experienced intraoperative complications, whereas three in the LNF group of whom two required reinterventions. The observed percentage of postoperative complications was 5% in the RNF group compared to 15% in the LNF group (p = 0.625). The operative times in the RNF group significantly dropped towards the second study period (p = 0.024).

Conclusions: Utilizing SSS^® for NF procedures in children is safe and feasible. Observational results may tentatively suggest that growing experiences and continued development will lead to better outcomes based on more accurate and safe surgery for children.

Keywords: Laparoscopic Nissen Fundoplication; Nissen Fundoplication; children; gastroesophageal reflux disease; pediatric patients; robotic-assisted Nissen Fundoplication; robotic-assisted surgery; senhance surgical system.

Grants and funding

This research received no external funding.