title: Computer-assisted robotic heller myotomy: initial case report.
abstract: OBJECTIVE
  Our objective was to determine the efficacy of computer-assisted robotic laparoscopic Heller myotomy.
  
  
  METHODS
  A 76-year-old woman with a significant history of achalasia was evaluated for laparoscopic Heller myotomy. The daVinci surgical system was used throughout the procedure.
  
  
  RESULTS
  Computer assistance allowed scaling of hand motions from a range of 2:1 to 5:1. Successful dissection of the esophageal musculature was accomplished, and a Toupet-type fundoplication was performed. The patient was discharged from the hospital the day after surgery with five port incisions, each <1 cm.
  
  
  CONCLUSIONS
  Telemanipulator computer-assisted surgical devices may have applications in procedures that require advanced and finely tuned motions, such as Heller myotomy. The benefits of extra magnification and three-dimensional imaging can help prevent esophageal perforation and identify residual circular muscle fibers.
authors.affiliation: The Center for Minimally Invasive Surgery, The Ohio State University Medical Center, Columbus, USA.
authors.forename: W S
authors.initials: WS
authors.lastname: Melvin
authors.forename: B J
authors.initials: BJ
authors.lastname: Needleman
authors.forename: K R
authors.initials: KR
authors.lastname: Krause
authors.forename: R K
authors.initials: RK
authors.lastname: Wolf
authors.forename: R E
authors.initials: RE
authors.lastname: Michler
authors.forename: E C
authors.initials: EC
authors.lastname: Ellison
mesh_terms: D000368:Aged; D013505:Digestive System Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D004931:Esophageal Achalasia / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D018662:Fundoplication / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000379:methods*