Bruno Zilberstein, MD, PHD, FACS, Thiago Manesco, MD, Leandro Barchi, MD, PHD, FACS, Willy Petrini Souza, MD. Gastromed
Achalasia is a condition that affects 01 to 03 individuals in 100,000 and is consequent to denervation of the esophagus, compromising its peristalsis and relaxation of the lower esophageal sphincter (LES). From an etiological point of view in South America, mainly in Brazil, the most com- mon cause is Chagas’ disease, with destruction of Meissner and Auerbach plexuses by Trypanosoma cruzi.
As complementary examinations, a barium radiograph (upper G.I.) constituites the main diagtnostic examination, and the upper endoscopy is perfomed to avoid an associated neoplasm.
When it comes to megaesophagus with a dolico megaesofaghus or a relapse of syntoms after heller’s operation, reoperations are more complex to be accomplished.
Options are esophagectomy with gastroplasty or jejunal interposition. In Brazil, due to the large number os patients with advanced megaesophagus, the frequent failure of conservative treatment and to avoid esophagectomy, the Serra-doria operation was proposed in 1970.
This technique consists in Grondhal cardioplasty ( latero-lateral esofagogastrostomy between the lower esophagus in the last 6cm above the cardia and gastric fundus, close to the hiss angle) associated to partial gastrectomy with Roux-en-Y gastrojejunal reconstruction.
The Objective of this report is to show the application of this technique through a robotic minimally invasive access for the treatment of recurrent achalasia after heller’s cardiomyotomy.
Conclusion: The use of robotic technology for reintervention on the esophagogastric junction facilitates its accomplishment and allows extremely complex precedures to be performed minimally invasively.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95416
Program Number: V158
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop