Technique and follow-up of minimally invasive Heller myotomy for achalasia

A. Iqbal, M. Haider, K. Desai, N. Garg, J. Kavan, S. Mittal, C. J. Filipi

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Background: Laparoscopic Heller myotomy has been proven effective. Reliable predictive factors for outcome and the true benefit of the da Vinci robotic system, however, remain unknown. Methods: Seventy patients underwent laparoscopic Heller myotomy. The number of intraoperative perforations and the symptom-predictive value of postoperative esophagogram width measurement at the gastroesophageal junction were analyzed. Results: The overall complication rate was 11%. Four patients experienced intraoperative perforation during the laparoscopic technique. No perforations were experienced with the da Vinci robotic system (n = 19). Of the total, 82% of patients had resolution of dysphagia, 91% of regurgitation, 91% of heartburn and 82% of chest pain. Immediate postoperative esophagogram gastroesophageal junction width demonstrated a positive predictive trend from 0 to 10 mm for dysphagia. Conclusion: Laparoscopic Heller myotomy is an effective treatment for achalasia. Immediate postoperative esophagogram gastroesophageal junction width measurement as a predictor for symptom resolution requires further study.

Original languageEnglish (US)
Pages (from-to)394-401
Number of pages8
JournalSurgical Endoscopy and Other Interventional Techniques
Volume20
Issue number3
DOIs
StatePublished - Mar 2006

Keywords

  • Da Vinci
  • Esophagogram
  • Heller myotomy
  • Laparoscopy

ASJC Scopus subject areas

  • Surgery

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