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Robotic redo Heller myotomy: how I do it?

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Abstract

Background

Despite the high success rate associated with Heller myotomy in the treatment of primary achalasia, symptom persistence or relapse occurs in approximately 10–20% of patients. Unfortunately, the ideal treatment after failed myotomy is not well established yet. We present a didactical video with a stepwise technique to perform a robotic revisional procedure after failed Heller myotomy.

Methods

In this report, each surgical step is thoroughly described and visually represented with useful technical tips that might help in improving surgical results of revisional Heller myotomy.

Results

In patients with previous surgical myotomy, the robotic platform with its high-definition magnified view and EndoWrist instruments allow for a safe and precise redo surgical myotomy.

Conclusions

Despite its improved surgical capabilities, the role of robotic redo Heller myotomy in the treatment algorithm of patients with recurrent symptoms after failed surgical myotomy should be further explored.

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Acknowledgements

The authors would like to thank Ashley Farinelli for the voice contribution to the video herein presented.

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Authors and Affiliations

  1. Division of General, Minimally Invasive and Robotic Surgery, University of Illinois at Chicago, 840 S Wood Street, Suite 435 E, Clinical Sciences Building, Chicago, IL, 60612, USA

    Antonio Cubisino, Francisco Schlottmann, Nicolas H. Dreifuss, Carolina Baz, Alberto Mangano, Mario A. Masrur, Francesco M. Bianco & Pier Cristoforo Giulianotti

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  1. Antonio Cubisino
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  2. Francisco Schlottmann
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  3. Nicolas H. Dreifuss
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  4. Carolina Baz
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  7. Francesco M. Bianco
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  8. Pier Cristoforo Giulianotti
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Contributions

Study conception and design: A. Cubisino; F. Schlottmann; N.H. Dreifuss; P.C. Giulianotti.

Acquisition of data: A. Cubisino; F. Schlottmann; N.H. Dreifuss; C. Baz; A. Mangano; M.A. Masrur; F.M. Bianco; P.C. Giulianotti.

Analysis and interpretation of data: A. Cubisino; F. Schlottmann; N.H. Dreifuss;

Drafting of manuscript: A. Cubisino; F. Schlottmann; N.H. Dreifuss; C. Baz; A. Mangano; M.A. Masrur; F.M. Bianco; P.C. Giulianotti.

Critical revision of manuscript: A. Cubisino; F. Schlottmann; N.H. Dreifuss; C. Baz; A. Mangano; M.A. Masrur; F.M. Bianco; P.C. Giulianotti.

Corresponding author

Correspondence to Antonio Cubisino.

Ethics declarations

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Pier Cristoforo Giulianotti has a consultant agreement with Covidien/Medtronic and Ethicon Endosurgery, and he also has an institutional agreement (University of Illinois at Chicago) for training with Intuitive. All other authors have no conflict of interest.

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Cubisino, A., Schlottmann, F., Dreifuss, N.H. et al. Robotic redo Heller myotomy: how I do it?. Langenbecks Arch Surg 407, 1721–1726 (2022). https://doi.org/10.1007/s00423-022-02553-1

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  • DOI: https://doi.org/10.1007/s00423-022-02553-1

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