Measuring Tension During Robotic Hiatal Hernia Repair Crural Closure with Force-Feedback Instruments on the da Vinci dV5 Platform

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The study assessed whether da Vinci 5 force-feedback instruments could quantify crural closure tension and crural stiffness during robotic hiatal hernia repair.
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Crural closure tension includes axial force related to esophageal shortening and radial force across the hiatus, while crural tissue compliance is currently assessed subjectively.
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The retrospective, single-institution cohort included 76 patients undergoing primary or revisional robotic repair between January 2024 and December 2025.
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Force measurements were retrieved from system logs and were not available to surgeons during operations; 32 of 108 cases were excluded for missing or unreliable data.
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The exploratory Crural Stiffness Index was defined as peak force per centimeter of crural displacement, with clinical validation and decision support identified as future research stages.

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