Objective:

Assess the feasibility of quantifying crural closure tension (CCT) and an exploratory Crural Stiffness Index (CSI) during robotic hiatal hernia repair using da Vinci 5 force-feedback instruments.

Approach:

• Design and setting: Retrospective, single-institution cohort of robotic hiatal hernia repairs performed from January 2024 through December 2025 by one fellowship-trained foregut surgeon.
• Participants: The analysis included 76 patients with symptomatic sliding or paraesophageal hernias. Thirty-two of 108 measured cases were excluded because of missing or corrupted records, measurement errors, or inability to determine initial defect width.
• Measurements: Force telemetry and operative video were used to assess defect width, crural displacement, and force during closure. CSI was defined as peak force per centimeter of crural displacement. Force measurements were collected retrospectively and were not available t…

Key Findings:

• The study describes a method for measuring CCT and CSI during robotic crural closure using dV5 force-feedback instruments.
• The supplied context does not report numerical measurement results or clinical outcomes.

Interpretation:

The work is presented as a proof of concept and an initial step toward clinical validation, outcome prediction, and possible intraoperative decision support.

Limitations:

• Retrospective analysis at a single institution involving one surgeon.
• Thirty-two cases were excluded because of data or measurement problems.
• Anesthesia depth and degree of paralysis were not standardized.
• The surgeon selected adjunctive measures, including mesh and relaxing incisions, based on operative findings.
• Force measurements were unavailable to the surgeon during the study procedures.

Sources:

• Article context provided