Robotic Heller-Dor for Idiopathic Achalasia: the Pisa experience

Santi, Stefano; Belluomini, Mario Antonio; D’Imporzano, S; Bellomini, Maria Grazia; Solito, Biagio; Gianetri, Debora; Giusti, Patrizia; Pallabazzer, Giovanni

doi:10.1007/s13304-021-01092-6

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…The use of NGT for achalasia surgery is still controversial. Many authors routinely place NGT after this surgery, others insert it before, but they say nothing about its removal [54][55][56]. However, it is not clear if other authors use it [57][58][59][60][61][62][63].…”

Section: Discussionmentioning

confidence: 99%

Nasogastric tube after laparoscopic Heller-Dor myotomy: do you really need it?

Palomba

Basile

Capuano

et al. 2023

Preprint

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Background Achalasia is a rare esophageal motor disorder. Laparoscopic Heller-Dor myotomy (LHD) is among the most effective treatments. The use of nasogastric tube (NGT) following LHD is still controversial. The aim of our study was to evaluate the role of NGT in achalasia patients undergoing LHD. Methods We prospectively enrolled achalasia patients treated with LHD from January 2019 until June 2022 at our institution and randomly assigned them to two groups: one group with NGT and group without (noNGT). Perioperative outcomes were compared between the two groups. ClinicalTrials.gov Identifier: NCT05729971. Results Seventy-nine patients who underwent LHD myotomy were prospectively enrolled. Patients were divided in two groups: 38 with NGT and 41 noNGT. There were no significant differences between two groups in terms of demographic data, preoperative characteristics, length of stay, start of liquid and solid diet, intraoperative and postoperative complications. First flatus was shorter in the noNGT group (p: 0.03). Conclusion Nasogastric tube placement following LHD myotomy does not reduce nausea, vomiting and chest pain, while it increased patients discomfort and time of first flatus.

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Section: Discussionmentioning

confidence: 99%

Nasogastric tube after laparoscopic Heller-Dor myotomy: do you really need it?

Palomba

Basile

Capuano

et al. 2023

Preprint

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Nasogastric tube after laparoscopic Heller-Dor surgery: Do you really need it?

Palomba,

Basile,

Capuano

et al. 2024

Current Problems in Surgery

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Robotic Heller’s cardiomyotomy for achalasia: early outcomes for a high-volume UK centre

Nevins,

Greene,

Bawa

et al. 2024

annals

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Introduction Heller’s cardiomyotomy (HCM) is the gold standard treatment for achalasia. Laparoscopic HCM has been shown to be effective with low rates of symptom recurrence, though oesophageal mucosal perforation rates remain high. The aim of this prospective case series is to assess the short-term complication rates and perioperative outcomes for the first cohort of patients undergoing robotic-assisted HCM for achalasia in a single high-volume UK centre. Methods Data were collected from a prospective cohort of patients who underwent robotic HCM at a single high-volume UK centre. Outcomes were assessed using the Eckhard score, which was calculated after their routine postoperative clinic appointments. Results Thirteen patients underwent robotic HCM during the study period; this is the second largest reported case series in the European literature. There were no intraoperative oesophageal perforations. Six patients were discharged as day cases, six patients were discharged on the first postoperative day and one patient’s hospital stay was two nights. There was a single perioperative complication of urinary retention. All patients reported improvement of symptoms following their operation, and all had a postoperative Eckhard score of less than 3, indicating their achalasia was in remission. Conclusions This cohort has demonstrated that robotic HCM has an exceptional safety profile and results in high levels of symptom resolution, even early in the learning curve. The robotic approach may be superior to laparoscopy as it allows more precise identification and dissection of the oesophageal muscle fibres, which likely reduces the risk of inadvertent mucosal damage or incomplete myotomy.

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Robotic Heller-Dor for Idiopathic Achalasia: the Pisa experience

Cited by 3 publications

References 12 publications

Nasogastric tube after laparoscopic Heller-Dor myotomy: do you really need it?

Nasogastric tube after laparoscopic Heller-Dor myotomy: do you really need it?

Nasogastric tube after laparoscopic Heller-Dor surgery: Do you really need it?

Robotic Heller’s cardiomyotomy for achalasia: early outcomes for a high-volume UK centre

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