WOFAPS 2025 8th World Congress of Pediatric Surgery

Yury Kozlov ¹, Alexander Rozansky ², Eduard Sapukhin ³, Andrey Marchuk ³, Roman Teschuk ³

¹ Irkutsk State Medical University, Department of Pediatric Surgery, Irkutsk
² Irkutsk State Medical Academy of Postgraduate Education, Department of Pediatric Surgery, Irkutsk
³ Irkutsk State Regional Children's Hospital, Department of Pediatric Surgery, Irkutsk

Purpose. Esophageal achalasia in children is a rare disease. Heller myotomy combined with Dor fundoplication remains the treatment of choice for this disease. Surgical approaches to implement this principle include open, laparoscopic and robotic approaches. This article describes the first experience of performing Heller robot-assisted myotomy in children.

Method. The study presents retrospective data on 3 children who was operated on for esophageal achalasia using a robot-assisted operation. The diagnosis of achalasia was established by contrast study of the esophagus and endoscopy of the upper gastrointestinal tract, as well as esophageal manometry. Heller robot-assisted myotomy was performed using the Versius surgical robot manufactured by CMR (UK).

Results. The average age at the time of surgery was 5.3±3.0 years (median – 6.0 [4.0; 7.0] years), and the average weight at the time of surgery was 17.3±8.7 kg (median – 15.0 [13.0; 21.0] kg). The average duration of the surgery was 140.0±25.9 minutes (median – 15.0 [13.0; 15.0] minutes), of which the main console time was 125.0±26.5 minutes (median – 115.0 [110.0; 135.0] minutes). All procedures were performed fully robotically without conversion to laparoscopy or open surgery. Surgical interventions were performed successfully without intraoperative difficulties and complications. The postoperative period was uneventful. The average length of stay in the intensive care unit was 23.6±0.6 hours (median – 24.0 [23.0; 24.0] hours). The average length of hospital stay was 3.6±0.6 days (median – 4.0 [3.0; 4.0] days). At 6 months after surgery, patients had no problems with urination, infection, and pain.

Conclusion. Robotic-assisted Heller myotomy for esophageal achalasia in children is safe and effective and is a good alternative to open and laparoscopic access.