Robotic Heller's cardiomyotomy for achalasia cardia with a long term follow up: a 16-year experience in a single institution.

Robotic surgical platforms facilitate accurate dissection with the help of high-definition 3D camera and greater freedom of manoeuvrability of robotic instruments. Aim was to evaluate short-term results (mucosal integrity and hospital stay) and long-term outcomes [symptom improvement and Quality of life (QoL)] of patients undergoing Robotic Heller's Cardiomyotomy (RHC). A retrospective analysis of data collected prospectively of achalasia patients undergoing primary RHC between July 2009 and June 2025 was performed. Information collected were demography, Eckardt symptom score (ESS), QoL scores with SF-36, type and stage of achalasia, peri and post-operative data. Sixty-eight patients underwent RHC (33-males). Median age was 46 years (18-82). Median length of myotomy was 8 cm (7-11). Median length of hospital stay was 2 days (1-28). One patient had aspiration pneumonia and DVT, and another had a postoperative leak needing emergency surgery. There was no mortality. Median follow-up was 102 months (3- 192). Twenty-one (31%) needed further intervention during follow-up. There was a significant improvement in ESS and in all components of QoL (p < 0.05). RHC can be performed accurately with a very low leak rate. RHC improves symptoms and quality of life and is an alternative to Laparoscopic Heller's Cardiomyotomy or per-oral endoscopic myotomy (POEM) in the Modern Era.