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Updated: Sep 9, 2025
Author Spotlight: Cutting-Edge Robotic Heller Myotomy Protocol for Treatment of Achalasia
Published on: February 16, 2024
30-day outcomes of robotic versus laparoscopic Heller myotomy
Paul J Brosnihan1, Ashkan Moazzez2,3, Junko J Ozao-Choy1
1Harbor UCLA Medical Center, 1000 W Carson Street, Box 461, Torrance, CA, 90509, USA.
Introduction:
Minimally invasive Heller myotomy has become the standard of care to treat patients with esophageal achalasia with improved morbidity and mortality compared to its open counterpart; however few studies have prospectively compared Robotic Heller myotomy (RAHM) to laparoscopic Heller myotomy (LHM).
Methods:
The 2022 ACS-NSQIP database was queried to identify adults with achalasia who underwent RAHM versus LHM. Patients in the RAHM group were matched using Coarsened Exact Matching with the LHM group on their preoperative characteristics. Chi-square and Fisher exact tests were used for categorical analysis, and Student's t-test was used for continuous data analysis. 30-day outcomes, including mortality, morbidity, operative time, length of hospital stay along with reoperation and readmission rates were compared between the two groups in both aggregate and matched cohorts.
Results:
In the aggregate cohort, patients in the RAHM were older (55.21 ± 16.28 vs. 49.71 ± 12.19, p = 0.007) and had a higher percentage of male patients (66.3% vs.49.5%, p = 0.011), but otherwise there were no statistically significant differences in co-morbidities between the two groups. In the matched cohort, there were no statistically significant differences in the preoperative characteristics between the two groups. There were no mortalities in the cohorts. In the aggregate cohort, RAHM was associated with higher morbidity (7.5% vs. 1.5%, p = 0.009) and longer operative times (166.65 ± 67.33 vs. 124.06 ± 52.61, p < 0.001). Similar findings were confirmed in the matched cohort. Overall surgical site infection (SSI), reintubation, deep vein thrombosis (DVT), and myocardial infarction (MI) were also higher in the RAHM group, but it did not reach statistical significance. There was no difference in readmission and reoperation rates, or length of stay between the two groups.
Conclusions:
In this study, RAHM had similar short-term outcomes compared to LHM, but may be associated with higher overall morbidity and longer operative times.
