The Treatment: Robotic-assisted esophageal Heller myotomy

digestive systemAchalasia is a fairly rare disorder of the esophagus that makes it difficult for an individual to swallow solid or liquid foods. It occurs when the esophageal sphincter muscle (located between the esophagus and the stomach) does not relax normally, making it hard for food to pass from the esophagus into the stomach. Patients often complain of chest pain and discomfort, usually experience regurgitation of undigested food, and face significant weight loss. The disease is progressive and generally gets worse over time.

Because medications are not effective in treating achalasia, surgery is the best definitive way to improve the condition. The esophageal Heller myotomy, where the circular muscle of the lower esophagus is cut and divided, results in decreasing the pressure on the lower esophageal sphincter muscle and this makes it easier to swallow.

At UC Davis, the GI surgery team specializes in treating achalasia patients with a robotic-assisted, laparoscopic esophageal Heller myotomy. The procedure uses miniaturized instruments and tiny incisions, making it minimally invasive and helping decrease recovery times and enhanced outcomes.

Benefits to patients

  • Reduced complication rate 
  • Reduced pain and trauma to the body
  • Less post-operative pain and discomfort
  • Less risk of infection
  • Shorter hospital stay
  • Less scarring
  • Faster recovery and return to normal daily activities

Robotic-assisted Surgery: Less invasive, faster recovery

The GI surgery team at UC Davis Medical Center includes highly experienced and trained surgeons, nurses and technicians. Our team of surgeons have extensive training with the da Vinci® robotic surgical system. They are highly skilled and experienced in using it for several types of problems, including hiatal hernias and achalasia. This minimally invasive technique is part of the Division of Gastrointestinal Surgery's commitment to minimizing pain and length of convalescence, as well as improving outcomes and quality of life.

daVinci hand controls and viewer allow for precisionThe robotic-assisted procedure allows them to work through small keyhole incisions using pencil-sized, precision-guided instruments. During the operative procedure, he sits at a controlling console near the patient while an assistant surgeon is at the bedside next to the patient.  Our team watches the operative field through a video monitor and controls robotic arms that replicate his precise hand movements at the console.

In cases of achalasia, the robotic-assisted procedure enables us to cut muscles of the sphincter located between the esophagus and stomach, making it easier for food to pass through. Compared to traditional, "open" surgery through a large incision in the abdomen or side of the chest, patients undergoing a minimally invasive, robotic-assisted myotomy usually experience a faster and easier recovery and much less pain. After the surgery, patients usually need only a day or two in the hospital and are then able to recover at home.

The robotic surgical system at UC Davis Medical Center has been used successfully in hundreds of cases over the past six years. Most patients are able to return to normal activity in two to three weeks instead of the six to eight weeks with standard open surgeries. As with any surgical procedure, benefits cannot be guaranteed. Successful outcomes depend on both the patient and the procedure.