Achalasia is a rare disease in which the lower esophageal sphincter does not relax properly and patients have difficulty swallowing and typically regurgitate food. With the condition, the esophagus dialates and widens causing muscle contractions and increased dysfunction. Soon, the esophagus transforms from a tube that carries food to the stomach to a reservoir with areas of the lower esophagus pouching outward. Once this happens, patients experience complications from repeated aspiration and pulmonary infection, airway obstruction and may even develop squamous cell carcinoma. Achalasia affects men and women equally and is most commonly seen in those in their thirties to forties.
The preferred surgical approach for achalasia is a robotic transthoracic esophageal myotomy without an anti-reflux procedure. For 16 patients who underwent a robotic assisted thoracoscopic esophageal myotomy for achalasia, without an antireflux procedure, the following outcomes were reported:
- Median hospitalization was four days
- Postoperative esophagograms revealed excellent emptying into the stomach with no evidence of mucosal outpouching in all patients
- All patients reported a subjective improvement in dysphagia
- There were no mucosal injuries or conversion to a thoracotomy
- Six patients reported occasional mild reflux, with three requiring nonprescription antacids