SSAT - REFRACTORY ACHALASIA: ROBOTIC-ASSISTED DOR FUNDOPLICATION TAKEDOWN AND HIATAL HERNIA REPAIR, REDO HELLER MYOTOMY AND TOUPET FUNDOPLICATION

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REFRACTORY ACHALASIA: ROBOTIC-ASSISTED DOR FUNDOPLICATION TAKEDOWN AND HIATAL HERNIA REPAIR, REDO HELLER MYOTOMY AND TOUPET FUNDOPLICATION
Agustina A. Pontecorvo^*, Tamar Tsenteradze, Enrique F. Elli
Mayo Clinic Florida, Jacksonville, FL

Status post Heller myotomy and Dor Fundoplication, patient presented with recurrent dysphagia and aspiration. Preoperative work-up confirmed a diagnosis consistent with achalasia type I. The patient underwent a robotic-assisted Dor fundoplication takedown, Hiatal hernia repair and redo myotomy with Toupet fundoplication. Dense adhesions at the hiatus and the esophagus made this case challenging. The hiatus was dissected, and the Dor fundoplication was taken down. A bougie was introduced to tailor the longitudinal myotomy that was performed to extend the anterior myotomy. A toupet fundoplication was performed to complete the surgery. Intraoperative endoscopy showed no mucosal perforation.

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