Lindsay Nelson, DO, Alexander Marinica, DO, Fazaldin Moghul, DO, Abubaker Ali. Detroit Medical Center/Sinai-Grace Hospital
Introduction: Heller myotomies are a standard procedure for achalasia. Minimally invasive surgery has become a frequently utilized technique, with an increasing use of robotic procedures. Cold myotomies using blunt dissection are frequnetly used with laparoscopic surgery but not documented in use for robotic myotomies.
Case Presentation: 60 year old female with symptomatic refractory achalaisa undergoes a robotic heller myotomy after extentive workup and several therapeutic EGDs without relief. A robotic heller myotomy utilizing cold myotomy with Dor fundoplication is performed as described in the included video abstract. She reports successful improvement in symptoms post-operatively without any adverse events and no leak noted post-operatively.
Conclusion: Cold myotomy technique is an underutilized technique that can be performed to achieve effective myotomy for achalaisa during robotic surgery. While limited tactile feedback exists in robotic surgery compared to laparoscopic surgery, the enhancd 3D visualization and magnification allow for successful myotomy while avoid thermal injury and therefore delayed leaks secondary to mucosal injury.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95691
Program Number: V214
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop