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Related Concept Videos

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Related Experiment Video

Updated: Sep 17, 2025

Author Spotlight: Cutting-Edge Robotic Heller Myotomy Protocol for Treatment of Achalasia
09:46

Author Spotlight: Cutting-Edge Robotic Heller Myotomy Protocol for Treatment of Achalasia

Published on: February 16, 2024

838

Same Day Discharge After Minimally Invasive Heller Myotomy: One Surgeon's Experience.

Alberto Jarrin Lopez1, Cynthia Susai1, Jonathan D Svahn2

  • 1Department of Surgery, University of California San Francisco East Bay, Oakland, California, USA.

World Journal of Surgery
|July 4, 2025
PubMed
Summary

Minimally invasive Heller myotomy (MI-HM) with partial fundoplication can be safely performed as an ambulatory procedure, with high same-day discharge (SDD) rates and low complications. This approach offers potential cost savings and improved patient satisfaction for achalasia treatment.

Keywords:
esophagusgastrointestinallaparoscopyoutcomesstomach

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Area of Science:

  • Gastroenterology and Surgical Innovation
  • Minimally Invasive Surgery
  • Ambulatory Care

Background:

  • Minimally invasive Heller myotomy (MI-HM) with partial fundoplication is a standard treatment for achalasia.
  • Enhanced recovery after surgery (ERAS) protocols enable same-day discharge (SDD) for many procedures.
  • Data on MI-HM as an ambulatory procedure are limited.

Purpose of the Study:

  • To evaluate the feasibility and safety of MI-HM as an ambulatory procedure.
  • To determine same-day discharge (SDD) rates, postoperative complications, and reasons for delayed discharge.

Main Methods:

  • Retrospective review of 157 consecutive MI-HM cases (laparoscopic or robotic) with Dor fundoplication.
  • Preoperative evaluation included high-resolution manometry, endoscopy, and esophagram.
  • SDD defined as discharge on postoperative day 0; analysis of 30-day emergency department visits and complications.

Main Results:

  • 84.1% of patients achieved same-day discharge (SDD), with rates improving over time.
  • Complication rate was 2.6%, with no reinterventions or mortalities; 10.2% presented to the ED within 30 days.
  • Reasons for delayed discharge included patient preference, surgeon discretion, and emesis/aspiration.

Conclusions:

  • MI-HM is safe and feasible as an ambulatory procedure for achalasia treatment.
  • Ambulatory MI-HM demonstrates low complication and readmission rates.
  • This approach offers potential cost and resource management benefits.