Age is Just a Number: Outcomes of Robotic Hiatal Hernia Repair in Octogenarians

Background: Robot-assisted hiatal hernia repair has become increasingly popular in high-risk populations as a relatively low-risk, minimally invasive surgical option. As life expectancy rises, more octogenarians are being considered for surgery despite age-related comorbidities. However, data on the safety and efficacy of robotic repair in this population are limited. This single-center retrospective study evaluates postoperative outcomes and complications after robotic hiatal hernia repair in octogenarians. Methods: Patients aged ≥80 years who underwent repair between 2017 and 2024 were propensity score–matched in a 1:3 ratio to those <80 years based on sex, body mass index, hernia type, and surgery type. Multivariable regression analyses were used to assess differences in hospital stay and postoperative outcomes, with significance set at P < .05. Results: A total of 302 patients underwent robotic hiatal hernia repair, including 78 patients aged ≥80 years and 224 aged <80 years. The ≥80 group had a median age of 83 years compared with 69 years (P < .001), with no differences in sex, body mass index, hernia, or surgery type. There were no significant differences in total hospital hours (30 vs 31, P = .11), postoperative events (5.4% vs 7.7%, P = .42), or 30-day readmissions (2.2% vs 5.1%, P = 24). No mortality was observed in either group. Age was not a significant factor for postoperative events on multivariable regression analysis. Conclusions: Surgical outcomes did not differ significantly between patients aged ≥80 and <80 years who underwent robot-assisted hiatal hernia repair. Elective robotic-assisted hiatal hernia repair is safe in carefully selected octogenarians.