Computer-assisted robotic Heller myotomy: Initial case report

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.