Purpose: Our objective was to determine the efficacy of computer-assisted r
obotic laparoscopic Heller myotomy.
Methods: A 76-year-old woman with a significant history of achalasia was ev
aluated for laparoscopic Heller myotomy. The daVinci(TM) surgical system wa
s used throughout the procedure.
Results: Computer assistance allowed scaling of hand motions from a range o
f 2:1 to 5:1. Successful dissection of the esophageal musculature was accom
plished, and a Toupet-type fundoplication was performed. The patient was di
scharged from the hospital the day after surgery with five port incisions,
each < 1 cm.
Conclusions: Telemanipulator computer-assisted surgical devices may have ap
plications in procedures that require advanced and finely tuned motions, su
ch as Heller myotomy. The benefits of extra magnification and three-dimensi
onal imaging can help prevent esophageal perforation and identify residual
circular muscle fibers.