Laparoscopic Heller myotomy (LHM) has become the standard treatment option for achalasia. The incidence of esophageal perforation reported is about 5 to 10%. Robotic assisted Heller myotomy (RAHM) is emerging as a safe alternative to LHM. Data comparing both approaches is scant. The aim of this study is to compare RAHM vs. LHM in terms of efficacy and safety for treatment of achalasia. Methods: A total of 121 patients underwent surgical treatment of achalasia at 3 institutions. A retrospective review of prospectively collected perioperative data was performed. Patients were divided in 2 groups: group A or RAHM; 59 patients, and group B or LHM, composed of 62 patients. Results: All the patients presented dysphagia preoperatively.

* Operative time in-group A, decreased from 174±37 to 108±36 min, in the last 30 cases (p< 0.05). Conclusions: This study demonstrates that RAHM has proven to be safer than LHM, since it decreases the incidence of esophageal perforation to 0%. In spite the fact that, almost 50% of patients had previous treatment when compared with group B. At short-term follow-up, relief of dysphagia was equally achieved in both groups.