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Related Experiment Video

Updated: Jun 30, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
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Robotic Heller myotomy and modified Dor fundoplication.

Alexander Pohlman1,2,3, Zaid M Abdelsattar1,3,4

  • 1Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA

Multimedia Manual of Cardiothoracic Surgery : MMCTS
|November 19, 2025
PubMed
Summary

This study presents a robotic Heller myotomy and Dor fundoplication for end-stage achalasia, achieving complete dysphagia resolution. This minimally invasive approach offers a successful treatment for complex esophageal motility disorders.

Keywords:
Esophageal diseasesMinimally invasiveOesophagus

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Achalasia is an esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter and loss of peristalsis.
  • End-stage achalasia often presents with severe symptoms like dysphagia, necessitating advanced treatment strategies.
  • Previous treatments such as pneumatic dilation had failed in this patient, indicating a need for alternative surgical interventions.

Purpose of the Study:

  • To evaluate the efficacy and safety of robotic Heller myotomy with Dor fundoplication for end-stage achalasia.
  • To describe the surgical technique for robotic Heller myotomy and Dor fundoplication in a complex achalasia case.
  • To report the short-term outcomes regarding symptom resolution and patient recovery.

Main Methods:

  • A 67-year-old female with type II achalasia and prior failed pneumatic dilation underwent robotic Heller myotomy and Dor fundoplication.
  • The procedure involved a minimally invasive approach using four 8 mm ports for dissection and myotomy creation.
  • A 6 cm esophageal and 2 cm gastric myotomy was performed, followed by a modified Dor fundoplication.

Main Results:

  • The robotic procedure was successfully completed with no intraoperative complications.
  • The patient was discharged on postoperative Day 1 with a soft diet.
  • Complete resolution of dysphagia to solids and liquids was achieved postoperatively.

Conclusions:

  • Robotic Heller myotomy and Dor fundoplication is a safe and effective treatment for end-stage achalasia, even after failed prior interventions.
  • This minimally invasive technique allows for precise dissection and reconstruction, leading to rapid recovery and excellent symptom relief.
  • Robotic surgery offers a viable option for complex achalasia cases, improving patient outcomes and quality of life.