Related Experiment Video
Updated: Aug 20, 2026
Robotic Heller Myotomy for Advancements in Surgical Management of Achalasia
Published on: February 16, 2024
Robot-assisted laparoscopic Heller cardiomyotomy: preliminary UK results
1Department of Surgical Oncology and Technology, Imperial College, St. Mary's Hospital, London, UK. s.undre@imperial.ac.uk
Insights
Robot-assisted laparoscopic Heller cardiomyotomy offers a viable treatment for achalasia cardia. This minimally invasive approach provides excellent outcomes without the need for an additional antireflux procedure.
Area of Science:
- Gastroenterology
- Surgical Technology
- Minimally Invasive Surgery
Background:
- Achalasia cardia is a condition treated with laparoscopic Heller cardiomyotomy.
- Robot-assisted surgery presents a novel approach to this procedure.
Purpose of the Study:
- To evaluate the initial experience and outcomes of robot-assisted laparoscopic Heller cardiomyotomy.
- To assess the feasibility and benefits of this technique without an antireflux procedure.
Main Methods:
- Five patients with achalasia cardia underwent robot-assisted laparoscopic Heller cardiomyotomy.
- Diagnosis was confirmed via radiology and manometry prior to surgery.
Main Results:
- All five procedures were successfully completed robotically, with no conversion to open surgery.
- One patient experienced a robotic-sutured mucosal perforation.
- Mean follow-up showed 4 patients asymptomatic and 1 with symptomatic improvement.
Conclusions:
- Robot-assisted surgery provides enhanced dexterity and 3D vision, ideal for Heller cardiomyotomy.
- Minimal dissection with robotic instruments may eliminate the need for an antireflux procedure.
Background/Aim:
Laparoscopic Heller cardiomyotomy is an established modality in the surgical treatment of patients having achalasia cardia. We present our initial experience in robot-assisted laparoscopic Heller cardiomyotomy without addition of an antireflux procedure and discuss the relative merits and disadvantages of the procedure.
Patients And Methods:
Five patients underwent robot-assisted laparoscopic Heller cardiomyotomy between August 2001 and October 2002. The diagnosis had been confirmed by radiology and manometry in all patients prior to surgery.
Results:
All procedures were completed successfully using the robotic system, without conversion to open procedure. Mucosal perforation occurred in 1 patient and was sutured robotically. The average operative time was 114.8 (range 65-160) min which is comparable to laparoscopic procedures. After a mean follow-up period of 9.4 (range 3-17) months, 4 patients remained completely asymptomatic, and 1 patient has benefited from symptomatic improvement.
Conclusions:
The enhanced dexterity and the high-quality three-dimensional vision available with robot-assisted surgery make the application of this technology highly suitable for Heller cardiomyotomy. The minimal lateral and posterior dissection due to the wristed instruments avoids the need for an antireflux procedure.
