International Society For Minimally Invasive Cardiothoracic Surgery

Back to 2019 Abstracts

Robotic Laparoscopic Lateral Heller Myotomy Without Fundoplication For Achalasia
Nabiha Atiquzzaman, Barbara Tempesta, Mark Meyer, Farid Gharagozloo, MD.
Florida Hospital Celebration Health/ University of Central Florida, Celebration, FL, USA.

Background: It is postulated that anterior Heller myotomy results in disruption of the Gastroesophageal valve (GEV), thereby resulting in wide open reflux and requiring an antireflux procedure. We hypothesized that a myotomy lateral to the GEV would leave the valve intact and obviate the need for an antireflux procedure. We sought to compare Robotic Laparoscopic Lateral Heller Myotomy without a Fundoplication (RLHM) to Robotic Laparoscopic Anterior Heller Myotomy with Dor Fundoplication (RAHM). Methods: We retrospectively studied patients with achalasia who underwent RLHM vs. RAHM . Patients were studied via 24-hour pH study and manometry at 6 months postoperatively. Dysphagia and GERD were final outcome variables. Pathologic GER was defined as distal esophageal time acid exposure time greater than 4.2% per 24-hour period. The outcome variables were analyzed on an intention-to-treat basis. Results: Thirty-eight patients were enrolled. There were no differences in the baseline characteristics between study groups. Median Postoperative dysphagia Score was 1 (range 0-1) with RLHM and 3 (range 0-4) with RAHM (P = 0.015). Pathologic GER occurred in 1of 24 patients (4.2%) after RLHM and in 2 of 24 patients (8.3%) after RAHM. Median Acid Exposure and Demeester Scores were similar when comparing RLHM to RAHM . Conclusions: The results of this study indicate that RLHM results in greater relief of dysphagia while preventing GER to the same level as RAHM.

Back to 2019 Abstracts
Brooklyn Bridge
New York City Skyline
Statue of Liberty
Radio City Music Hall
By using this site, you agree to our updated Privacy Policy.  Got it