Alonso Andrade, Matthew K. Folstein, Brian R. Davis

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Presentation transcript:

Case report of robotic dor fundoplication for scleroderma esophagus with aperistalsis on manometry Alonso Andrade, Matthew K. Folstein, Brian R. Davis International Journal of Surgery Case Reports Volume 37, Pages 69-71 (January 2017) DOI: 10.1016/j.ijscr.2017.06.020 Copyright © 2017 The Authors Terms and Conditions

Fig. 1 Barium swallow showing normal deglutition, Dilated smooth esophagus with a smooth stenosis at the EG junction. Retained food in the esophagus with slow passage of contrast into esophagus with decreased peristalsis. Findings consistent with achalasia. International Journal of Surgery Case Reports 2017 37, 69-71DOI: (10.1016/j.ijscr.2017.06.020) Copyright © 2017 The Authors Terms and Conditions

Fig. 2 High resolution esophageal manometry showing low LES pressures and aperistalsis. Mean LES pressure: 5mmHg (abnormal <15%), LES Percent Relaxation: 56%, Percent Failed Propulsive Swallows: 100%, and Contraction Amplitudes: <20% (very low). International Journal of Surgery Case Reports 2017 37, 69-71DOI: (10.1016/j.ijscr.2017.06.020) Copyright © 2017 The Authors Terms and Conditions

Fig. 3 Courtesy of DaVinci Online Community. Standard Procedure Card for foregut surgery. For our Robotic Dor Fundoplication Camera port, Port 2 and Port 1 were used. Port B was used for a Nathanson liver retractor. The Assistant Port A and Port 3 were not used. International Journal of Surgery Case Reports 2017 37, 69-71DOI: (10.1016/j.ijscr.2017.06.020) Copyright © 2017 The Authors Terms and Conditions

Fig. 4 Intraoperative endoscopy showing no evidence of injury to esophagus, no evidence of narrowing at GE junction. Shown here is a retroflex view with GE junction valve consistent with fundoplication. International Journal of Surgery Case Reports 2017 37, 69-71DOI: (10.1016/j.ijscr.2017.06.020) Copyright © 2017 The Authors Terms and Conditions

Fig. 5 Intraoperative view of completed anterior Dor Fundoplication as seen in surgeon console. International Journal of Surgery Case Reports 2017 37, 69-71DOI: (10.1016/j.ijscr.2017.06.020) Copyright © 2017 The Authors Terms and Conditions