Robotic versus Laparoscopic and Open Type IV Hiatal Hernia Repair: An STS General Thoracic Surgery Database…

Cohort studyThe Annals of thoracic surgery· Jul 2026

Robotic versus Laparoscopic and Open Type IV Hiatal Hernia Repair: An STS General Thoracic Surgery Database Analysis.

Christina S Boutros, Omkar S Pawar, Aria Bassiri … Christopher W Towe

Read paper

Hernia & Abdominal WallCohort studyTreatmentQ1IF 2.5

Open thoracotomy repair carries higher odds of major postoperative complications than robotic repair.

Robotic versus Laparoscopic and Open Type IV Hiatal Hernia Repair: An STS General Thoracic Surgery Database Analysis.

Christina S Boutros … Christopher W Towe

The Annals of thoracic surgery · Jul 2026 · Q1 in Surgery

Background

Robotic techniques are increasingly used for complex diaphragmatic hernia repair; however, their safety in type IV hiatal hernias remains uncertain.

Methods

Were stratified by operative approach: robotic, laparoscopic, laparotomy, and thoracotomy.

n = 2,714 patients

Results

open thoracotomy repair carries higher odds of major complications than robotic

42.5%

Thoracotomy

35.9%

Laparotomy

27.5%

Laparoscopic

23.3%

Robotic

More results

A total of 2,714 patients underwent repair: 1,281 laparoscopic (47.2%), 1,112 robotic (41.0%), 128 laparotomy (4.7%), and 193 thoracotomy (7.1%).

Major postoperative events occurred most frequently after thoracotomy (42.5%) and laparotomy (35.9%), compared with laparoscopic (27.5%) and robotic repair (23.3%).

More results

Readmission and mortality were similar across approaches.

“

Conclusion · 1 of 2

Minimally invasive approaches, including laparoscopic and robotic techniques, are associated with favorable perioperative outcomes compared with open repair.

Conclusion · 2 of 2

These findings support the use of minimally invasive surgery for type IV hiatal hernias when clinically appropriate.

Robotic versus Laparoscopic and Open Type IV Hiatal Hernia Repair: An STS General Thoracic Surgery Database Analysis.

Robotic versus Laparoscopic and Open Type IV Hiatal Hernia Repair: An STS General Thoracic Surgery Database Analysis.

Related papers