Laparoscopic Heller myotomy for achalasia facilitated by robotic assistance

Abstract

The findings showed RAHM to be safe and effective, with a 0% incidence of perforation and relief of symptoms for 91% of the patients.

Robotic Foregut Surgery: One Surgeon’s Experience with Nissen Fundoplication, Esophagomyotomy, and Hiatal Hernia Repair

“…The published literature reports a perioperative complication average of 7.3% (0 -24) for robotic Nissen fundoplication patients [4][5][6][7][8][9][10][11][12][13], 6.4% (3 -13) for esophagomyotomy patients [16][17][18][19], and 15% (0 -31) for hiatal hernia repair patients [19][20][21]. Our series had similar results with 7% of Nissen fundoplication patients, 15% of esophagomyotomy patients, and 11% of hiatal hernia repair patients experiencing perioperative complications.…”

Robot-assisted Heller’s myotomy for achalasia in children

“…[4] Primary clinical symptoms are dysphagia, vomiting, nocturnal cough and failure to thrive if the disorder is left untreated. [3] The current treatment goal is symptomatic relief. [4] There are several treatment options including oral medications, botulinum toxin injection to the lower esophageal sphincter, pneumatic or mechanical esophageal dilatation and endoscopic or surgical myotomy.…”

“…[4] There are several treatment options including oral medications, botulinum toxin injection to the lower esophageal sphincter, pneumatic or mechanical esophageal dilatation and endoscopic or surgical myotomy. [2][3][4][5] Controversy still exists concerning which treatment option is the best due to the rarity of the disease in children, the presence of multiple treatment modalities and a lack of randomized controlled studies in this age group. [12] Despite the lack of a definite conclusion, advances and refinements in laparoscopy in pediatrics, a low rate of complications, a high rate of success and faster recovery have shifted the treatment preference toward laparoscopic Heller's myotomy.…”

“…In a comparative study of 121 myotomies in adults, there were no cases of mucosal perforation in the robotic myotomy group, but mucosal perforation occurred in 16% of patients in the laparoscopic group. [3] Another advantage of a robotic procedure is telesurgery, which can potentially be used in situations or environments in which it is difficult to transport a patient or a surgeon. [8] In a large retrospective comparative study including 2683 adult patients who underwent open, laparoscopic or robotic Heller's myotomy, Shaligram et al found no differences between the laparoscopic and robotic procedures in terms of morbidity, mortality, length of hospital stay or readmission rate.…”

“…[2] Surgical options include open surgery, laparoscopy and recently, a robotic approach. [2][3][4] Few case reports have been published on robotic-assisted Heller's myotomy in children. [5][6][7][8][9][10][11] The aim of this report is to describe our experience with robotic-assisted Heller's myotomy in children and to review the literature.…”