Peroral endoscopic myotomy achieves similar clinical response but incurs lesser charges compared to robotic heller myotomy

Khashab, Mouen A.; Kumbhari, Vivek; Tieu, Alan H.; Zein, Mohamad H. El; Ismail, Amr; Ngamruengphong, Saowanee; Singh, Vikesh K.; Kalloo, Anthony N.; Clarke, John O.; Stein, Ellen M.

doi:10.4103/1319-3767.203360

Cited by 27 publications

(2 citation statements)

References 22 publications

(37 reference statements)

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“… 35 Another publication from the USA has also demonstrated that LHCM is significantly cheaper than RHCM (US$7,441±7,897 vs US$9,415±5,515). 34 Although cost reduction strategies are likely to arise with the increasing utilisation of robotics, 32 , 34 , 36 at present the robotic approach should be considered to be more expensive.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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show abstract

“…The improved visualization and precision control are thought to contribute to fewer mucosal perforations and enable the execution of longer myotomy incisions. On the flip side, when considering drawbacks of robotic operations, several studies underscore the cost factor 8,9 .…”

Section: Discussionmentioning

confidence: 99%

Robotic Heller Myotomy

Gabrielle Epstein,

Garbato,

Maccapani

et al. 2024

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Achalasia is an esophageal motor disorder characterized by the failure of the lower esophageal sphincter (LES) to relax and the loss of peristalsis in the esophageal body.Treatment options aim to alleviate the elevated pressure of the LES and include direct botulinum toxin injection, pneumatic dilation, per-oral endoscopic myotomy (POEM), and Heller myotomy.Traditionally, laparoscopic Heller myotomy with partial fundoplication has been the gold standard for treating achalasia. However, the robotic approach is gaining popularity for

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Long-term outcomes of per-oral endoscopic myotomy compared to laparoscopic Heller myotomy for achalasia: a single-center experience

et al. 2020

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Peroral endoscopic myotomy achieves similar clinical response but incurs lesser charges compared to robotic heller myotomy

Cited by 27 publications

References 22 publications

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

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

Robotic Heller Myotomy

Long-term outcomes of per-oral endoscopic myotomy compared to laparoscopic Heller myotomy for achalasia: a single-center experience

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