To explore the feasibility of using the advantages of robotic surgical system to perform tension-free repair of esophageal hiatus hernia, central pancreatectomy and end-to-end anastomosis.

Minimally invasive surgical approach for the central pancreatectomy was optimized, and by robot the hiatus hernia contents were release and reset, the hiatus was narrowed, mesh was placed and fixed, and fundoplication was performed. Then we continued to excise the middle part of the pancreas, and put no. 8 tube into the proximal and distal pancreatic duct, and then performed end-to-end pancreatic anastomosis.

In addition to avoiding the patient′s second operation and reducing the number of operative holes, the patient recovered well after the operation. CT review showed that the gastric fundus was well repositioned, the pancreatic tumor had been removed, the end-to-end anastomosis of the pancreas was in good alignment, and the tube position was normal. Postoperative pathology revealed negative proximal and distal cutting margins.

The case report in this paper is the first in China to use robotic surgical system to perform transabdominal tension-free repair of esophageal hiatus hernia, fundoplication combined with central pancreatectomy, pancreatic duct formation, and end-to-end anastomosis. The success of treatment in this case is helpful to provide experience and ideas for future combined surgical treatment of multiple diseases.