Robotic redo Heller myotomy: how I do it?

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

doi:10.1007/s00423-022-02553-1

Cited by 1 publication

(1 citation statement)

References 32 publications

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“…Finally, the surgeon ideally should create a partial valve covering the myotomy, carefully avoiding obstruction in the new fundoplication, although there has yet to be a consensus on the type of valve among specialists. Despite no existing controlled studies, robotic platforms could be helpful for revisional surgery if available due to the enhanced visualization and movement degrees of freedom 6 .…”

Section: Methodsmentioning

confidence: 99%

Management of Symptoms Recurrence After Myotomy for Achalasia. A Practical Approach

TUSTUMI,

SZACHNOWICZ,

ANDREOLLO

et al. 2023

ABCD, arq. bras. cir. dig.

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BACKGROUND: Achalasia is an esophageal motility disorder, and myotomy is one of the most used treatment techniques. However, symptom persistence or recurrence occurs in 9 to 20% of cases. AIMS: This study aims to provide a practical approach for managing the recurrence or persistence of achalasia symptoms after myotomy. METHODS: A critical review was performed to gather evidence for a rational approach for managing the recurrence or persistence of achalasia symptoms after myotomy. RESULTS: To properly manage an achalasia patient with significant symptoms after myotomy, such as dysphagia, regurgitation, thoracic pain, and weight loss, it is necessary to classify symptoms, stratify severity, perform appropriate tests, and define a treatment strategy. A systematic differential diagnosis workup is essential to cover the main etiologies of symptoms recurrence or persistence after myotomy. Upper digestive endoscopy and dynamic digital radiography are the main tests that can be applied for investigation. The treatment options include endoscopic dilation, peroral endoscopic myotomy, redo surgery, and esophagectomy, and the decision should be based on the patient’s individual characteristics. CONCLUSIONS: A good clinical evaluation and the use of proper tests jointly with a rational assessment, are essential for the management of symptoms recurrence or persistence after achalasia myotomy.

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Section: Methodsmentioning

confidence: 99%