Digestive Surgery
Original Paper
Robot-Assisted Laparoscopic Heller Cardiomyotomy: Preliminary UK ResultsUndre S. · Moorthy K. · Munz Y. · Aggarwal R. · Hance J. · Rockall T. · Darzi A.Department of Surgical Oncology and Technology, Imperial College, St. Mary’s Hospital, London, UK
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Article / Publication Details
Received: July 21, 2004
Accepted: August 09, 2004
Published online: February 21, 2005
Issue release date: February 2005
Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 1
ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)
For additional information: https://www.karger.com/DSU
Abstract
Background/Aim: Laparoscopic Heller cardiomyotomy is an established modality in the surgical treatment of patients having achalasia cardia. We present our initial experience in robot-assisted laparoscopic Heller cardiomyotomy without addition of an antireflux procedure and discuss the relative merits and disadvantages of the procedure. Patients and Methods: Five patients underwent robot-assisted laparoscopic Heller cardiomyotomy between August 2001 and October 2002. The diagnosis had been confirmed by radiology and manometry in all patients prior to surgery. Results: All procedures were completed successfully using the robotic system, without conversion to open procedure. Mucosal perforation occurred in 1 patient and was sutured robotically. The average operative time was 114.8 (range 65–160) min which is comparable to laparoscopic procedures. After a mean follow-up period of 9.4 (range 3–17) months, 4 patients remained completely asymptomatic, and 1 patient has benefited from symptomatic improvement. Conclusions: The enhanced dexterity and the high-quality three-dimensional vision available with robot-assisted surgery make the application of this technology highly suitable for Heller cardiomyotomy. The minimal lateral and posterior dissection due to the wristed instruments avoids the need for an antireflux procedure.
© 2004 S. Karger AG, Basel
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References
- Hunter JG, Trus TL, Branum GD, Waring JP: Laparoscopic Heller myotomy and fundoplication for achalasia. Ann Surg 1997;225:655–664.
- West RL, Hirsch DP, Bartelsman JF, de Borst J, Ferwerda G, Tytgat GN, Boeckxstaens GE: Long term results of pneumatic dilation in achalasia followed for more than 5 years. Am J Gastroenterol 2002;97:1346–1351.
- Csendes A: Results of surgical treatment of achalasia of the esophagus. Hepatogastroenterology 1991;38:474–480.
-
Heller E: Extramuköse Kerioplastic beim chronischen Kardiospasmus mit Dilatation des Oesophagus. Mitt Grenzgeb Med Chir (Jena) 1914;27:141–145.
- Beckingham IJ, Callanan M, Louw JA, Bornman PC: Laparoscopic cardiomyotomy for achalasia after failed balloon dilatation. Surg Endosc 1999;13:493–496.
- Katilius M, Velanovich V: Heller myotomy for achalasia: Quality of life comparison of laparoscopic and open approaches. JSLS 2001;5:227–231.
- Gallagher AG, Satava RM: Virtual reality as a metric for the assessment of laparoscopic psychomotor skills: Learning curves and reliability measures. Surg Endosc 2002;16:1746–1752.
- Berguer R: Surgery and ergonomics. Arch Surg 1999;134:1011–1016.
- Shea JA, Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN, Schwartz JS, Williams SV: Mortality and complications associated with laparoscopic cholecystectomy: A meta-analysis. Ann Surg 1996;224:609–620.
- Moorthy K, Munz Y, Dosis A, Hernandez J, Martin S, Bello F, Rockall T, Darzi A: Dexterity enhancement with robotic surgery. Surg Endosc 2004;18:790–795.
- Yohannes P, Rotariu P, Pinto P, Smith AD, Lee BR: Comparison of robotic versus laparoscopic skills: Is there a difference in the learning curve? Urology 2002;60:39–45.
-
Hernandez J, Bann S, Munz Y, et al: The learning curve of a simulated surgical task using the da Vinci telemanipulator system. Br J Surg 2002;234:475–484.
-
Hashizume M, Konishi K, Tsutsumi N, Yamaguchi S, Shimabukuro R: A new era of robotic surgery assisted by a computer-enhanced surgical system. Surgery 2002;131(1 Suppl):S330–S333.
External Resources
- Kim VB, Chapman WH, Albrecht RJ, Bailey BM, Young JA, Nifong LW, Chitwood WR Jr: Early experience with telemanipulative robot-assisted laparoscopic cholecystectomy using da Vinci. Surg Laparosc Endosc Percutan Tech 2002;12:33–40.
- Gould JC, Melvin WS: Computer-assisted robotic antireflux surgery. Surg Laparosc Endosc Percutan Tech 2002;12:26–29.
- Ruurda JP, Broeders IA, Simmermacher RP, Rinkes IH, van Vroonhoven TJ: Feasibility of robot-assisted laparoscopic surgery: An evaluation of 35 robot-assisted laparoscopic cholecystectomies. Surg Laparosc Endosc Percutan Tech 2002;12:41–45.
- Undre S, Munz Y, Moorthy K, Martin S, Rockall T, Vale J, Darzi A: Robot-assisted laparoscopic adrenalectomy: Preliminary UK results. BJU Int 2004;93:357–359.
- Ackroyd R, Watson DI, Devitt PG, Jamieson GG: Laparoscopic cardiomyotomy and anterior partial fundoplication for achalasia. Surg Endosc 2001;15:683–686.
- Ellis FH Jr, Crozier RE, Watkins E Jr: Operation for esophageal achalasia: Results of esophagomyotomy without an antireflux operation. J Thorac Cardiovasc Surg 1984;88:344–351.
- Robertson GS, Lloyd DM, Wicks AC, de Caestecker J, Veitch PS: Laparoscopic Heller’s cardiomyotomy without an antireflux procedure. Br J Surg 1995;82:957–959.
- Kumar V, Shimi SM, Cuschieri A: Does laparoscopic cardiomyotomy require an antireflux procedure? Endoscopy 1998;30:8–11.
- Esposito C, Cucchiara S, Borrelli O, Roblot-Maigret B, Desruelle P, Montupet P: Laparoscopic esophagomyotomy for the treatment of achalasia in children: A preliminary report of eight cases. Surg Endosc 2000;14:110–113.
Article / Publication Details
Received: July 21, 2004
Accepted: August 09, 2004
Published online: February 21, 2005
Issue release date: February 2005
Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 1
ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)
For additional information: https://www.karger.com/DSU
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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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