Robotic Heller-Dor myotomy: 10-year monocentric experience compared with POEM

Achalasia is a rare motility disorder caused by an incomplete relaxation of the lower esophageal sphincter and loss of esophageal peristalsis. As a consequence, the bolus swallowing is hindered and the patients complain dysphagia, regurgitation, chest pain, respiratory symptoms and weight loss. Achalasia’s treatment has been varied over time, from therapies aiming to relax the lower sphincter of the esophagus, including drugs and Botox injection or mechanical dilatations, to surgical myotomy. Robotic or laparoscopic Heller-Dor procedure is considered the gold standard surgical treatment for symptomatic achalasia as it is proved to be effective and safe. As an alternative, Per-Oral Endoscopic Myotomy (POEM) was applied over the past decade, aiming to combine the same results of mini-invasive procedure to the advantages of endoscopic approach. In this study, we are going to compare the medium-long term results of mini-invasive Heller-Dor procedure, routinely performed in our Department, with those of POEM reported in literature.