Uzunoglu Mustafa, Altintoprak Fatih, Yalkin Omer, Özdemir Kayhan
General Surgery, Bursa City Hospital, Bursa, TUR.
General Surgery, Sakarya University, Serdivan, TUR.
Cureus. 2022 Jan 23;14(1):e21510. doi: 10.7759/cureus.21510. eCollection 2022 Jan.
Background The outcomes of surgical interventions for achalasia treatment improved with the advent of minimally invasive surgery and the introduction of robotic surgery. This article describes the technical details of robotic achalasia surgery, shares our initial experiences, and discusses why robotic surgery will become the first choice for the surgical treatment of achalasia. Methods The records of patients with a diagnosis of achalasia who underwent robotic surgery were evaluated retrospectively. The patients' data were examined in terms of demographic parameters, duration of complaints, treatment options applied previously, robotic surgery technique, and postoperative outcomes. Results Of the six patients evaluated, four (66.7%) were males and two (33.3%) were females. Their mean age was 32 years (20-51 years), and the mean symptom duration was 4.6 years (2-9 years). All of the patients underwent robotic Heller cardiomyotomy surgery. After the myotomy procedure, five of the six patients (83.3%) underwent partial anterior fundoplication (Dor) as an antireflux procedure. The cruroraphy procedure was performed in one patient (16.7%) due to accompanying hiatal hernia, whereas the procedures were completed in five patients (83.3%) without performing posterior dissection of the oesophagus. In the postoperative follow-up period, no surgical problem was encountered, while reflux symptoms developed in one patient (16.7%) and were controlled by medical therapy. Conclusions The success of surgical treatment of achalasia is incontrovertible. Due to the various advantages of robotic surgery, it is now frequently used in narrow-area surgeries, such as achalasia surgery.
背景 随着微创手术的出现和机器人手术的引入，贲门失弛缓症手术治疗的效果得到了改善。本文描述了机器人贲门失弛缓症手术的技术细节，分享了我们的初步经验，并讨论了机器人手术为何将成为贲门失弛缓症手术治疗的首选。方法 对诊断为贲门失弛缓症并接受机器人手术的患者记录进行回顾性评估。从人口统计学参数、症状持续时间、先前应用的治疗选择、机器人手术技术和术后结果等方面检查患者数据。结果 在评估的6例患者中，4例（66.7%）为男性，2例（33.3%）为女性。他们的平均年龄为32岁（20 - 51岁），平均症状持续时间为4.6年（2 - 9年）。所有患者均接受了机器人Heller贲门肌切开术。肌切开术后，6例患者中有5例（83.3%）接受了部分前胃底折叠术（Dor）作为抗反流手术。1例患者（16.7%）因伴有食管裂孔疝而进行了膈脚缝合术，而5例患者（83.3%）未进行食管后游离即完成了手术。在术后随访期间，未遇到手术问题，1例患者（16.7%）出现反流症状，经药物治疗得到控制。结论 贲门失弛缓症手术治疗的成功是无可争议的。由于机器人手术具有多种优势，它现在经常用于狭窄区域的手术，如贲门失弛缓症手术。
