How does the robot affect outcomes? A retrospective review of open, laparoscopic, and robotic Heller myotomy for achalasia

  title={How does the robot affect outcomes? A retrospective review of open, laparoscopic, and robotic Heller myotomy for achalasia},
  author={Abhijit Shaligram and Jayaraj Unnirevi and Anton Simorov and Vishal Kothari and Dmitry Oleynikov},
  journal={Surgical Endoscopy},
BackgroundRobotic techniques are routinely used in urological and gynecological procedures; however, their role in general surgical procedures is limited. A robotic technique has been successfully adopted for a minimally invasive Heller myotomy procedure for achalasia. This study aims to compare perioperative outcomes following open, laparoscopic, and robotic Heller myotomy.MethodsThis study is a multicenter, retrospective analysis utilizing a large administrative database. The University… 
How does robotic anti-reflux surgery compare with traditional open and laparoscopic techniques: a cost and outcomes analysis
Current data suggests that robot-assisted NF procedures have similar patient outcomes to conventional laparoscopic NF, with the exception of added cost and higher re-admission rate.
Overall Complications Following Robotic Heller Myotomy Are Lower Compared With Laparoscopy
Robotic Heller myotomy is associated with lower overall complications and improved outcomes compared with laparoscopic HellerMyotomy, even in high-volume centers despite the reduction in overall complications.
Robotic versus laparoscopic approach to treat symptomatic achalasia: systematic review with meta-analysis.
The robotic approach is found to be associated with a significantly significant lower rate of intraoperative esophageal perforations, encouraging the use of robot-assisted surgery.
Peroral Endoscopic Myotomy Achieves Similar Clinical Response but Incurs Lesser Charges Compared to Robotic Heller Myotomy
  • M. Khashab, V. Kumbhari, E. Stein
  • Medicine
    Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association
  • 2017
POEM when performed in an endoscopy unit was similar in efficacy and safety to RHM, however, POEM was associated with significant cost savings ($3301/procedure).
Utilization and outcome of laparoscopic versus robotic general and bariatric surgical procedures at Academic Medical Centers
This national analysis of academic centers showed a low utilization of robotic-assisted laparoscopic elective general and bariatric surgical procedures with the highest utilization for rectal resection.
Efficacy and durability of robotic heller myotomy for achalasia: patient symptoms and satisfaction at long-term follow-up
Durable dysphagia relief is demonstrated in the vast majority of patients with a high degree of patient satisfaction and a low rate of esophageal mucosal injury in a dearth of long-term follow-up data.
Robot-assisted Heller’s myotomy for achalasia in children
Robotic-assisted Heller’s myotomy for esophageal achalasia in children is safe and effective and is a suitable alternative to open and laparoscopic approaches.
Role of robotic-assisted surgery in benign esophageal diseases
A single surgeon’s experience in management of benign esophageal diseases by robotic-assisted surgery over a period of 8 consecutive years is reported, finding that when performed by an experienced surgeon, robotic- assisted surgery is safe and effective in the management of malicious esophagia/reflux/dysphonia.
Heller myotomy perforation: robotic visualization decreases perforation rate and revisional surgery is a perforation risk
It is proposed that the robotic platform provided the surgeon with superior ability to avoid perforation during Heller myotomy, and further prospective trials be done to better evaluate the benefits of robotic platform in regard to revisional foregut surgery.
Robot-assisted Laparoscopic Esophagomyotomy Versus Laparoscopic Esophagomyotomy for Treatment of Esophageal Achalasia: Siriraj Experience
It is concluded that robotic surgery is equivalent in feasibility and safety to conventional LEM and RA-LEM may be associated with less blood loss and shorter hospital stay.


Laparoscopic Heller myotomy for achalasia facilitated by robotic assistance
The findings showed RAHM to be safe and effective, with a 0% incidence of perforation and relief of symptoms for 91% of the patients.
Application of robotics in general surgery: initial experience.
Robotic surgery was recently approved for clinical use in general abdominal surgery and is feasible and safe; however, the theoretical advantages of the da Vinci surgical system were not clinically apparent.
Efficacy of the Da Vinci Surgical System in Abdominal Surgery Compared With That of Laparoscopy: A Systematic Review and Meta-Analysis
DVSS was found to be associated with fewer Heller myotomy-related perforations, a more rapid intestinal recovery time after gastrectomy—and therefore a shorter hospital stay, a short hospital stay following cholecystectomy, and longer colorectal resection surgery times, and a larger number of conversions to open surgery during gastric bypass.
Laparoscopic Heller myotomy with Toupet fundoplication: outcomes predictors in 121 consecutive patients.
Dysphagia improves in most patients after laparoscopic Heller myotomy with partial fundoplication, and patients with severe preoperative dysphagia, esophageal dilation, or amotile achalasia may have greater chances of a poor outcome.
A prospective analysis of 211 robotic-assisted surgical procedures
The results of robotic-assisted surgery compare favorably with those of conventional laparoscopy with respect to mortality, complications, and length of stay.
Technique and follow-up of minimally invasive Heller myotomy for achalasia
Immediate postoperative esophagogram gastroesophageal junction width demonstrated a positive predictive trend from 0 to 10 mm for dysphagia, and laparoscopic Heller myotomy is an effective treatment for achalasia.