Robotic redo Heller myotomy: how I do it?

Authors :: Cubisino A
Schlottmann F
Dreifuss NH
Baz C
Mangano A
Masrur MA
Bianco FM
Giulianotti PC
Source :: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2022 Jun; Vol. 407 (4), pp. 1721-1726. Date of Electronic Publication: 2022 May 18.
Publication Year :: 2022
Abstract: Background: Despite the high success rate associated with Heller myotomy in the treatment of primary achalasia, symptom persistence or relapse occurs in approximately 10-20% of patients. Unfortunately, the ideal treatment after failed myotomy is not well established yet. We present a didactical video with a stepwise technique to perform a robotic revisional procedure after failed Heller myotomy.<br />Methods: In this report, each surgical step is thoroughly described and visually represented with useful technical tips that might help in improving surgical results of revisional Heller myotomy.<br />Results: In patients with previous surgical myotomy, the robotic platform with its high-definition magnified view and EndoWrist instruments allow for a safe and precise redo surgical myotomy.<br />Conclusions: Despite its improved surgical capabilities, the role of robotic redo Heller myotomy in the treatment algorithm of patients with recurrent symptoms after failed surgical myotomy should be further explored.<br /> (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)