World's First Snake-Arm Single-Port Robot Used for Complex Diaphragmatic Hernia Repair

Background

Diaphragmatic hernias involve defects in the diaphragm that allow abdominal organs to enter the chest cavity. Esophageal hiatal hernia occurs when part of the stomach pushes through the diaphragm's esophageal opening, often leading to gastroesophageal reflux or other complications. Complex cases can present additional surgical challenges due to the location near critical structures including the esophagus, major blood vessels, heart and lungs.

Conventional surgical approaches have progressed from open procedures to laparoscopic techniques and robotic-assisted surgery to improve precision while reducing invasiveness. Traditional laparoscopic or multi-port robotic methods typically require multiple abdominal incisions. Reports from July 2025 highlighted advancements by teams at The First Affiliated Hospital of Fujian Medical University in applying new domestically developed single-port robotic technology to these procedures.

What was achieved

According to a July 22, 2025 report, a surgical team from the hospital's hepatobiliary pancreatic surgery and hernia surgery departments achieved multiple world firsts. On June 25, 2025, Chief Physician Liu Guozhong, under the leadership of hospital Party Secretary Professor Weng Shangeng, successfully performed the world's first snake-arm single-port robotic esophageal hiatal hernia repair combined with Nissen fundoplication. The procedure was completed on a young patient using only a single approximately 2.5 cm incision at the umbilicus.

The patient recovered and was discharged from the hospital three days after surgery. In the days immediately following, the team completed the world's first snake-arm single-port robotic complex diaphragmatic hernia repair as well as a bilateral inguinal hernia repair using the same technology. These cases represented three global firsts in the application of the domestic snake-arm single-port robot for different types of hernia repairs within a brief period.

How it works

Single-port robotic surgery channels the camera and instruments through one small incision, in these cases about 2.5 cm at the umbilicus, via a multi-channel access port. The snake-arm system uses flexible, multi-jointed arms that can bend and rotate with a high degree of freedom. This allows navigation and operation in deep, confined abdominal spaces such as the esophageal hiatus region, overcoming limitations of rigid straight instruments that can interfere with each other in single-incision settings.

The surgeon operates from a console with three-dimensional high-definition visualization. This provides magnified views for millimeter-level precision in tissue dissection, reduction of herniated organs, closure of the diaphragmatic defect with sutures, and performance of the Nissen fundoplication. In fundoplication, the fundus of the stomach is mobilized and wrapped around the lower esophagus to create a reinforcing valve that helps prevent acid reflux. Similar precise manipulation was applied to the more complex diaphragmatic hernia case.

What it means for international patients

The hospital's Binhai campus functions as Huashan Hospital Fujian Hospital, a national regional medical center, and includes an International Medical Department. This department provides services for overseas Chinese compatriots and international patients, featuring English-language support from proficient staff, one-on-one patient escort and accompaniment, bilingual translation, and English medical records.

International patients considering advanced single-port robotic techniques for hernia repair or similar minimally invasive procedures should contact the hospital directly. Eligibility, current availability of the specific snake-arm single-port robotic system, preoperative assessment requirements, and all care arrangements must be confirmed on an individual basis with the hospital, as suitability depends on each patient's specific medical condition and evaluation by the clinical team.

About the hospital

The First Affiliated Hospital of Fujian Medical University is located in Fuzhou, Fujian Province. Founded in 1937, it was the first public hospital practicing Western medicine in the province. It is a large comprehensive tertiary Grade A hospital affiliated with Fujian Medical University that integrates clinical services, medical education and scientific research.

The facility operates across four campuses including Chating, Binhai, Aoti and Minnan, with a total of 4,500 authorized beds, making it the largest hospital in Fujian. It is designated a provincial high-level hospital and participates in national initiatives including projects to enhance diagnosis and treatment capacity for difficult diseases and as the leading unit for the rare disease collaboration network in Fujian. In 2025, it recorded 2.8049 million outpatient and emergency visits, 156,400 discharged patients and more than 100,000 surgical procedures. The hospital maintains an International Medical Department and has developed capabilities in robotic-assisted minimally invasive surgery.