Robotic Esophageal Myotomy
Esophageal myotomy is a procedure performed by a thoracic surgeon to help people with achalasia swallow.
It involves cutting away some of the outer layers of tissue from the lower esophagus to allow food and liquids to pass into the stomach more easily.
Robotic esophageal myotomy is done in an operating room, with a specially trained surgical staff. Patients are under general anesthesia and constantly monitored by an anesthesiologist.
During this procedure:
- The thoracic surgeon makes five tiny incisions in the abdominal wall
- Carbon dioxide gas inflates the abdomen to create a working space for the surgeon
- Tiny surgical instruments and a tiny camera are attached to robotic arms and precisely inserted through the incisions
- The surgeon then sits at a nearby console, controlling every movement of the robotic arms
- The surgeon cuts the outer layer of muscles in the lower esophageal sphincter
- The surgeon performs an anti-reflux procedure called “fundoplication”
- The instruments are removed and the incisions closed
Fundoplication involves wrapping part of the upper stomach around the lower end of the esophagus and suturing it in place. This supports the valve between the esophagus and stomach and helps prevent stomach acid from entering the esophagus.
All surgeries involve some degree of risk, and discussing this with your doctor is an important part of preparing for any surgery. Fortunately, complications from robotic surgery are rare.
Historically, open myotomies were done to access the esophagus through a large incision in the left chest. The minimally invasive alternative has been laparoscopy, which uses long, straight instruments inserted through small incisions in the patient’s chest.
Now thoracic surgeons at Swedish offer robotic myotomy, an advanced technique which offers advantages over standard laparoscopy in surgery, including:
- Greater precision with the use of “wristed” surgical instruments
- The ability to see in 3-D
- A magnified view of the surgical area
Patients who have had a robotic myotomy typically:
- Leave the hospital in one to two days
- Return to normal activities within one week
Because achalasia is a rare disease, esophageal myotomies are not frequently done. This makes it particularly important to find an experienced surgeon who works in a specialty center where robotic surgeries are routinely performed.
When you interview surgeons you are considering, be sure to ask:
- How many patients with achalasia do they care for each year?
- How many myotomies are performed in their center each year?
- How long has robotic surgery been available at the hospital?
- How many robotic surgeries are done there?
Swedish is one of the few centers in the Northwest to offer robotic myotomy, and our thoracic surgeons are among the most experienced in the country. They present their data nationally, and surgeons from other hospitals regularly come to Swedish to observe and learn from them.
More than 4,000 robotic procedures have been performed here and everyone on our robotic surgery teams is specially trained and highly experienced