Robotic Hiatal Hernia Repair in Tampa: What to Expect
Hiatal hernias—especially paraesophageal or large hernias—can cause troublesome reflux, chest discomfort, or complications like strangulation. Many patients are familiar with laparoscopic repair. But at Tampa Bay Reflux Center, we also offer robotic hiatal hernia repair for select patients. This technique blends minimally invasive surgery with robotic precision.
In this article, you’ll learn:
What robotic hiatal hernia repair is
How it differs from laparoscopic repair
Benefits, risks, and expected recovery
How we guide patients through decision-making
What Is Robotic Hiatal Hernia Repair?
Robotic hiatal hernia repair is a minimally invasive surgical approach in which surgeons use a robotic surgical system (e.g. the da Vinci platform) to assist in repairing the hiatal hernia, reinforcing the diaphragm (crural repair), and often performing a fundoplication (wrapping the stomach or placing an anti-reflux mechanism).
Compared to standard laparoscopy, the robotic system offers:
Wristed instruments (greater articulation)
3D magnified stereoscopic vision
Tremor filtration and finer control
These advantages can help in more delicate dissection around the esophagus, suturing the crura, and managing challenging anatomy or adhesions.
What the Evidence Says
Safety & Outcome Comparisons
In a retrospective comparative study, robotic hiatal hernia repair was associated with lower rates of postoperative ileus and fewer ICU visits, and showed reduced symptom recurrence at 1 year versus laparoscopic repair (Bassiri et al., 2025).
Another study comparing robotic-assisted vs conventional laparoscopic hiatal hernia repair found that hospital stay and complication rates were largely similar between the two techniques (Tjeerdsma et al., 2022).
A comparison of robotic vs laparoscopic repair of type II/III hiatal hernias noted no significant differences in adverse outcomes, suggesting robotic safety is comparable (Kooiker et al., 2024).
In select high-risk or complex cases (e.g. paraesophageal hernias), a narrative review found robotic repair to be feasible with perioperative outcomes similar to laparoscopic approaches (Grenda & Reddy, 2022).
However, some data point to caution: a registry-based study indicated that robotic repairs had higher rates of complications and readmissions compared to laparoscopic approaches in some settings (Klock et al., 2023).
Limitations & Variability
Robotic procedures can be longer, particularly early in a surgeon’s learning curve.
Equipment and operating room costs tend to be higher.
The surgeon’s experience and volume play a crucial role in outcomes—centers with more robotic experience tend to mitigate many of the potential downsides.
Some large database analyses show higher complication risk in robotic groups in unadjusted data, though adjustments for case mix, surgeon volume, and patient comorbidities often shift results.
In summary, when done in experienced hands and in appropriate patients, robotic hiatal hernia repair appears to offer safety comparable to laparoscopic repair, with some possible incremental benefits in recovery or complication reduction.
What Patients Should Expect: The Journey
Here’s a patient-focused view of what to anticipate before, during, and after robotic hiatal hernia repair:
Before Surgery
Preoperative evaluation: imaging (CT, barium swallow), endoscopy, esophageal manometry, pH testing
Risk assessment: your overall health, prior abdominal surgeries, lung function
Discussion of options: we’ll review whether robotic, laparoscopic, or hybrid approaches suit your case best
During Surgery
3–5 small incisions (ports)
The surgical team docks the robot, inserts robotic arms, dissects the hernia sac, mobilizes the esophagus, repairs the crura, and often performs a fundoplication or reinforces the repair with mesh if needed
Surgeons may switch to conventional laparoscopic or open technique (“conversion”) if encountered difficulties
After Surgery & Recovery
Most patients spend 1–2 nights in the hospital (though same-day discharge may be possible in select low-risk cases)
Expect moderate pain initially, controlled with medications
Diet will advance progressively (liquids → soft foods → regular diet)
Activity guidelines: light walking immediately, gradual return to normal within a few weeks
Follow-up includes imaging or endoscopy to assess for recurrence and symptom resolution
Benefits Patients Often Experience
Smaller incisions and less trauma than open surgery
Possibly faster return of bowel function and fewer complications like ileus (shown in some robotic vs laparoscopic comparisons)
Better access in anatomically challenging fields—robotic tools can aid in tight posterior or mediastinal dissection
Potentially lower recurrence of symptoms in certain patient subgroups (based on preliminary findings)
Reduced risk of ICU stay or prolonged support (in some comparative data)
Risks & Considerations
Intraoperative risks: bleeding, organ injury, esophageal injury, perforation
Postoperative risks: hernia recurrence, dysphagia (difficulty swallowing), gas bloat, delayed emptying, mesh complications
Conversion risk: in cases of dense scar tissue or unexpected anatomy, the surgeon may need to shift to a different surgical method
Longer operative time and higher cost in many settings, especially early in adoption
Dependence on technology: rare risk of robotic system malfunction or instrument failure
Because of these risks, candidacy, surgeon skill, and institutional support are key determinants of successful outcomes.
Why Choose Tampa Bay Reflux Center
At Tampa Bay Reflux Center, we bring together the elements you should look for in a robotic hiatal hernia program:
Surgeon expertise in both robotic and laparoscopic foregut surgery
Individualized patient evaluation — you are not just a “robotic candidate” or “laparoscopic candidate,” but assessed case by case
High-volume robotic platform to maintain proficiency and optimize outcomes
Transparent discussions of benefits, risks, costs, and expected recovery
Focus on long-term vigilance for recurrence and quality-of-life metrics
We’ll guide you from diagnosis through recovery, helping you make the best surgical decision for your condition.
Robotic hiatal hernia repair in Tampa offers a compelling option that combines minimally invasive technique with advanced robotic precision. Current evidence suggests that, when done well, its safety rivals that of conventional laparoscopic repair—with possible advantages in recovery, comfort, and management of challenging anatomy.
If you're considering hiatal hernia surgery and exploring robotic options, a consultation with Tampa Bay Reflux Center can help you understand whether you are a good candidate and what outcomes you can reasonably expect.
Works Cited
Bassiri, A., Pawar, O. S., Boutros, C., Jiang, B., Sinopoli, J., Tapias, L., Linden, P., & Towe, C. (2025). Robotic vs laparoscopic hiatal hernia repair: A comparative study of short- and long-term surgical outcomes. The Annals of Thoracic Surgery. [link]
Tjeerdsma, M., et al. (2022). Comparing outcomes of robotic-assisted versus conventional laparoscopic hiatal hernia repair. PMC. [link]
Kooiker, P., et al. (2024). Robotic-assisted versus laparoscopic repair of type II/III hiatal hernias: A comparative study. Annals of Medicine and Surgery, 85. [link]
Grenda, T. R., & Reddy, R. M. (2022). Application of robotic surgery for paraesophageal hiatal hernia repair: A narrative review. VATS / Video-Assisted Thoracic Surgery. [link]
Klock, J. A., et al. (2023). Robotic hiatal hernia repair associated with higher complication and readmission rates: analysis from nationwide database. Journal of Gastrointestinal Surgery. [link]