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Updated: Oct 8, 2025
Author Spotlight: Cutting-Edge Robotic Heller Myotomy Protocol for Treatment of Achalasia
Published on: February 16, 2024
Same-day discharge for laparoscopic Heller myotomy
Abdullah Al Jabri1, Jessica Liu2, Julie Takata2
1Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. asaljabri95@gmail.com.
Insights
Same-day discharge after laparoscopic Heller myotomy is safe and feasible. This approach shows similar complication and readmission rates compared to traditional inpatient stays for achalasia treatment.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Patient Outcomes
Background:
- Laparoscopic Heller myotomy is a standard treatment for achalasia.
- Limited data exists on the safety and feasibility of same-day discharge protocols following this procedure.
Purpose of the Study:
- To evaluate the safety and feasibility of same-day discharge after laparoscopic Heller myotomy.
- To compare outcomes between patients discharged on the same day and those admitted as inpatients.
Main Methods:
- Retrospective cohort study of 209 patients undergoing laparoscopic Heller myotomy (2007-2016).
- Comparison of planned same-day discharge versus planned inpatient groups.
- Analysis of post-operative complications, length of stay, and emergency visits.
Main Results:
- Same-day discharge was planned for 33.5% of patients.
- The same-day discharge group had fewer pre-operative comorbidities (1.6 vs. 2.3).
- Post-operative complication rates were 6.0% for same-day discharge versus 15% for inpatients; readmission rates were similar.
Conclusions:
- Same-day discharge is a feasible option for select laparoscopic Heller myotomy patients.
- Outcomes, including complications and readmissions, are comparable to inpatient management.
- This approach may offer benefits for achalasia treatment protocols.
Background:
Laparoscopic Heller myotomy is an effective treatment for achalasia. There are little data on the safety and feasibility of same-day discharge after laparoscopic Heller myotomy.
Objective:
This study aimed to describe the experience with same-day discharge after laparoscopic Heller myotomy at one hospital.
Methods:
A retrospective cohort study including all patients who underwent laparoscopic Heller myotomy between 2007 and 2016 at University Health Network (UHN), Toronto, Canada. There was no consent required as the study was retrospective study. This study was approved by the UHN IRB. Planned same-day discharge patients were compared to planned inpatient with respect to post-op complications, length of stay, and number of emergency visits.
Results:
A total of 209 patients were identified. Same-day discharge was planned in 67 (33.5%) cases compared to 133 (66.5%) cases that were planned for inpatient. The study population was 49% male. On average, inpatients had 2.3 pre-operative comorbidities and same-day discharge patients had 1.6 pre-operative comorbidities. The average length of stay for the inpatient group was 3.5 days. Among the same-day surgery group, 15 had an unplanned admission following surgery (22%). Of those who were admitted, the average length of stay was 1.27 days. Only 1 same-day discharge was readmitted after hospital discharge, while 4 in inpatient group were readmitted. The post-operative complication rate was (15%) 20 of inpatient compared to four (6.0%) of same-day discharge. Number of emergency visits for inpatient group were 7 (5.3%) compared to 3 (4.5%) for same-day discharge group. There was one mortality case in inpatient group due to post-op complication.
Conclusion:
Same-day surgery is feasible for laparoscopic Heller myotomy, with a similar complication and readmission rate as inpatient surgery.
