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Introduction <p>Failure of the cricopharyngeal muscle to relax leads to the formation of a cricopharyngeal (CP) bar which causes dysphagia and increased risk for aspiration. Open myotomy is one definitive treatment option; however, there are several drawbacks including a long neck incision, possible drain placement, and invasiveness of the procedure. We aim to share an updated dataset of our experience using the DaVinci robotic platform to perform a minimally invasive CP myotomy, which has never been described before prior to our original dataset.</p> Methods <p>We performed a retrospective review of consecutive robotic CP myotomies performed in adult patients by a single surgeon from August 2021 to March 2024. Outcomes of interest included length of procedure, time to diet resumption, hospital length of stay, complications, symptom improvement at follow-up, and symptom recurrence.</p> Results <p>Twenty-five robotic CP myotomies were performed. The median age was 72&#xa0;years old (62–91) and near evenly split between sexes (<i>n</i> = 13 female, 52%) with a median BMI of 28.5&#xa0;kg/m<sup>2</sup> (17.7–39.5). The median procedure length was 111&#xa0;min (75–141), and there were no intraoperative complications. All patients underwent a post-procedural esophagram with no leaks identified. All patients were started on a full liquid diet in the recovery room prior to discharge. Same-day discharge rate was 88%. Symptom resolution was reported in 23/24 patients (95.8%) who completed post-operative follow-up. There was one delayed subacute hematoma with wound dehiscence but no other complications and no readmissions. Two patients reported recurrent symptoms but only one with radiographic evidence of a recurrent cricopharyngeal bar.</p> Conclusion <p>Robotic cricopharyngeal myotomy represents a promising treatment for cricopharyngeal bars with cervical dysphagia with encouraging safety and efficacy.</p>

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Robotic cricopharyngeal myotomy for the treatment of cricopharyngeal bars

  • 期刊论文

  • 发表日期：

    2025年9月2日

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  • Jesse K. Kelley,
  • Allison Hoppe,
  • Apoorva Ojha,
  • Stephen Kuselias,
  • G. Dane Fritz,
  • Luke Sanford,
  • Giuseppe M. Zambito,
  • Amy L. Banks-Venegoni

摘要

Introduction

Failure of the cricopharyngeal muscle to relax leads to the formation of a cricopharyngeal (CP) bar which causes dysphagia and increased risk for aspiration. Open myotomy is one definitive treatment option; however, there are several drawbacks including a long neck incision, possible drain placement, and invasiveness of the procedure. We aim to share an updated dataset of our experience using the DaVinci robotic platform to perform a minimally invasive CP myotomy, which has never been described before prior to our original dataset.

Methods

We performed a retrospective review of consecutive robotic CP myotomies performed in adult patients by a single surgeon from August 2021 to March 2024. Outcomes of interest included length of procedure, time to diet resumption, hospital length of stay, complications, symptom improvement at follow-up, and symptom recurrence.

Results

Twenty-five robotic CP myotomies were performed. The median age was 72 years old (62–91) and near evenly split between sexes (n = 13 female, 52%) with a median BMI of 28.5 kg/m2 (17.7–39.5). The median procedure length was 111 min (75–141), and there were no intraoperative complications. All patients underwent a post-procedural esophagram with no leaks identified. All patients were started on a full liquid diet in the recovery room prior to discharge. Same-day discharge rate was 88%. Symptom resolution was reported in 23/24 patients (95.8%) who completed post-operative follow-up. There was one delayed subacute hematoma with wound dehiscence but no other complications and no readmissions. Two patients reported recurrent symptoms but only one with radiographic evidence of a recurrent cricopharyngeal bar.

Conclusion

Robotic cricopharyngeal myotomy represents a promising treatment for cricopharyngeal bars with cervical dysphagia with encouraging safety and efficacy.