ArticleSurgical endoscopy2020
Robotic and per-oral endoscopic myotomy have fewer technical complications compared to laparoscopic Heller myotomy.
Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06290882 (Endoscopic Versus Robotic Myotomy for Treatment of Achalasia), which is not on this map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Endoscopic Versus Robotic Myotomy for Treatment of Achalasia (ERMA Trial)
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Robotic versus laparoscopic heller myotomy for esophageal achalasia: an updated systematic review and meta-analysis.Langenbeck's archives of surgery · 2025Pooled it
- Comparative long-term outcomes of Heller myotomy and peroral endoscopic myotomy.Surgical endoscopy · 2026Article
- Initial experience of benign upper gastrointestinal robotic-assisted surgery: first 200 cases and early postoperative outcomes.Annals of the Royal College of Surgeons of England · 2025Article
- Comparing peroral endoscopic myotomy and laparoscopic Heller myotomy for esophageal motility disorders: Nationwide cohort study.Endoscopy international open · 2025Article
- The impact of robotic surgery on the treatment of benign esophageal and gastric disease: early experience of a specialized unit.Journal of robotic surgery · 2024Article
- Endoscopic versus robotic myotomy for treatment of achalasia (ERMA trial): protocol for a randomized clinical multicentre trial.BJS open · 2024Article
- Robotic Heller's cardiomyotomy for achalasia: early outcomes for a high-volume UK centre.Annals of the Royal College of Surgeons of England · 2024Article
- Single-center experience of transitioning from video-assisted laparoscopic to robotic Heller myotomy with Dor fundoplication for esophageal motility disorders.BMC surgery · 2023Observational
- Robot-Assisted Heller Myotomy Versus Laparoscopic Heller Myotomy: A Systematic Review and Meta-Analysis.Cureus · 2023Review
- Mixed Esophageal Disease (MED): A New Concept.Digestive diseases and sciences · 2023Review
- Endoluminal Functional Imaging Demonstrates Need for Myotomy During Epiphrenic Diverticulectomy.Annals of thoracic surgery short reports · 2023Article
- Clinical and functional outcome following robotic Heller-myotomy with partial fundoplication in patients with achalasia.Journal of robotic surgery · 2023Article
- Robotic-assisted foregut surgery is associated with lower rates of complication and shorter post-operative length of stay.Surgical endoscopy · 2023Article
- Pathogenesis, clinical manifestations, diagnosis, and treatment progress of achalasia of cardia.World journal of clinical cases · 2023Review
- From laparoscopic to robotic-assisted Heller myotomy for achalasia in a single high-volume visceral surgery center: postoperative outcomes and quality of life.BMC surgery · 2022Article
- Robotic Surgery for the Treatment of Achalasia Cardia: Surgical Technique, Initial Experiences and Literature Review.Cureus · 2022Article
- Rehospitalization, Treatment, and Resource Use After Inpatient Admission for Achalasia in the USA.Digestive diseases and sciences · 2021Observational
- Esophageal Achalasia: From Laparoscopic to Robotic Heller Myotomy and Dor Fundoplication.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAchalasia is an uncommon disease treated by decreasing the lower esophageal sphincter resting pressure. This study compared the safety and efficacy of esophago-gastric myotomy via laparoscopic, robotic, and per-oral endoscopic approaches.
methodsA retrospective review of data on patients with achalasia or other esophageal dysmotility disorder undergoing laparoscopic, robotically assisted, or per-oral endoscopic myotomy (POEM) procedures between 2013 and 2017 was performed. Patient demographics, comorbidities, procedure details, length of stay, 30-day readmission rate, and combined technical complication (full-thickness injury, conversion to open, and delayed perforation) were compared. Multiple logistic regression analysis was performed to determine which factors contributed to combined technical complication.
resultsThere were 171 patients who underwent esophago-gastric myotomy with 161 (94.2%) having achalasia. There were 40 laparoscopic Heller myotomies with partial fundoplication, 44 robotic Heller myotomies with partial fundoplication, and 87 POEM procedures performed during the study period. Baseline statistical differences were found among the groups in regard to gastroesophageal reflux symptoms, arrhythmia, hypertension, and congestive heart failure. Laparoscopic Heller myotomy had significantly higher combined technical complications (7, 17.5%) compared to robotically assisted Heller myotomy (0, 0%) and POEM (1, 1.1%). Multivariate analysis showed that laparoscopic Heller myotomy (OR 32.22; 95% CI 2.66, 389.83; p = 0.01), myocardial infarction (OR 27.94; 95% CI 1.66, 471.10; p = 0.02), and history of smoking (OR 8.87; 95% CI 1.29, 61.15; p = 0.03) were risks for developing combined technical complications.
conclusionRobotically assisted Heller myotomy and POEM are safe and efficacious treatments for achalasia with lower rates of technical complications compared to laparoscopic Heller myotomy. With the advancements in endoscopic instruments and robotic surgery, POEM and robotically assisted Heller myotomy should be considered in the treatment of achalasia and esophageal dysmotility disorders.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.