A Prospective, Single-Center Investigation of the da Vinci SP® Surgical System in Hepatopancreaticobiliary and Foregut Operations for Benign and Malignant Disease

Inclusion Criteria Cholecystectomy Stage 1 - Inclusion Criteria: * Patients between the ages of 18 and 80 years of age * Either male or female * BMI ≤ 26 kg/m2 * ASA ≤ 3 * Diagnosed with benign disease Fundoplication Stage 1- Inclusion Criteria: * Patients diagnosed with GERD and/or hiatal hernia * Patients between the ages of 18 and 80 years of age * Either men or women * BMI ≤ 26 kg/m2 * ASA ≤ 3 Gastrectomy Stage 2- Inclusion Criteria: * Patients between the ages of 18 and 80 years of age * Either men or women * BMI ≤ 26 kg/m2 * ASA ≤ 3 * Diagnosed with benign or relatively early malignant disease of the stomach * AJCC 8th edition T0 or T1 tumor pathology * AJCC 8th edition T2, T3, tumor pathology (following neoadjuvant therapy if necessary) at the discretion of the investigator * Free of metastatic disease Distal Pancreatectomy Stage 2- Inclusion Criteria: * Patients between the ages of 18 and 80 years of age * Either men or women * BMI ≤ 26 kg/m2 * ASA ≤ 3 * Diagnosed with benign or malignant disease of the pancreas * No vascular involvement * Free of metastatic disease Pancreaticoduodenectomy Stage 3- Inclusion Criteria: * Patients between the ages of 18 and 80 years of age * Either men or women * BMI ≤ 26 kg/m2 * ASA ≤ 3 * Diagnosed with benign or malignant disease of the pancreas * Diagnosed with benign or malignant distal bile duct disease * No vasculature involvement (i.e., no T4 disease, pancreatic or Stage 4a or b disease, or distal bile duct Stage 3b or 4 disease) * Free of metastatic disease Esophagectomy Stage 3- Inclusion Criteria: * Patients between the ages of 18 and 80 years of age * Either men or women * BMI ≤ 26 kg/m2 * ASA ≤ 3 * Diagnosed with benign or malignant disease of the esophagus * AJCC 8th edition T0, T1a, T1b, T2 (without other indications for neoadjuvant therapy) tumor pathology * AJCC 8th edition some T2, T3, or T4a, (following neoadjuvant therapy) at the discretion of the investigator * Free of metastatic disease Hepatectomy Stage 4- Inclusion Criteria: * Patients between the ages of 18 and 80 years of age * Either men or women * BMI ≤ 26 kg/m2 * ASA ≤ 3 * Diagnosed with benign or malignant disease of the liver or bile duct * Free of metastatic disease, not including metastatic disease to the liver (e.g., colorectal liver metastases) Exclusion Criteria Cholecystectomy Stage 1- Exclusion Criteria: * Subject requiring an emergent operation * Pregnancy or nursing * BMI \> 26 kg/m2 * Previous abdominal surgery * Subjects with malignant disease * Inability to provide informed consent * Contraindicated for general anesthesia or minimally invasive surgery Fundoplication Stage 1- Exclusion Criteria: * Subject requiring an emergent operation * Pregnancy or nursing * BMI \> 26 kg/m2 * Previous abdominal surgery * Inability to provide informed consent * Contraindicated for general anesthesia or minimally invasive surgery Gastrectomy Stage 2- Exclusion Criteria: * Subject requiring an emergency operation * Pregnancy or nursing * BMI \> 26 kg/m2 * Previous abdominal surgery * Inability to provide informed consent * Contraindicated for general anesthesia or minimally invasive surgery * AJCC 8th edition T2, T3, T4a, T4b tumor pathology (without neoadjuvant therapy unless contraindicated) * Clinical or radiological evidence of distant metastatic disease Distal Pancreatectomy Stage 2- Exclusion Criteria: * Subject requiring an emergent operation * Pregnancy or nursing * BMI \> 26 kg/m2 * Previous abdominal surgery * Inability to provide informed consent * Contraindicated for general anesthesia or minimally invasive surgery * Tumor involvement with surrounding vasculature (e.g., common hepatic artery, superior mesenteric artery, superior mesenteric vein, portal vein) * Clinical or radiological evidence of metastatic disease Pancreaticoduodenectomy Stage 3- Exclusion Criteria: * Subject requiring an emergent operation * Pregnancy or nursing * BMI \> 26 kg/m2 * Previous abdominal surgery * Inability to provide informed consent * Contraindicated for general anesthesia or minimally invasive surgery * Tumor involvement with surrounding vasculature (e.g., T4a for pancreatic disease: common hepatic artery, superior mesenteric artery, superior mesenteric vein, portal vein) * Tumor involvement with surrounding vasculature (e.g., T3b for bile duct disease: common hepatic artery, superior mesenteric artery, superior mesenteric vein, portal vein) * Clinical or radiological evidence of metastatic disease Esophagectomy Stage 3- Exclusion Criteria: * Subject requiring an emergency operation * Pregnancy or nursing * BMI \> 26 kg/m2 * Previous abdominal surgery * Inability to provide informed consent * Contraindicated for general anesthesia or minimally invasive surgery * AJCC 8th edition T2 (in some circumstances), T3, and T4a tumor pathology (without neoadjuvant therapy) * Clinical or radiological evidence of distant metastatic disease Hepatectomy Stage 4- Exclusion Criteria: * Subject requiring an emergency operation * Pregnancy or nursing * BMI \> 26 kg/m2 * Previous abdominal surgery * Inability to provide informed consent * Contraindicated for general anesthesia or minimally invasive surgery * Perihilar cholangiocarcinoma (i.e., Klatskin tumor) * Involvement of major vasculature (ex: portal vein, hepatic artery, or inferior vena cava) * Clinical or radiological evidence of metastatic disease