Robotic Treatment of Functional Esophagogastric Diseases

Functional esophagogastric diseases that are amenable to surgical treatment include primary motility disorders of the esophagus as well as gastroesophageal reflux disease and hiatal hernia. Achalasia is the most common esophageal motility disorder. Surgical treatment involves a myotomy—which is the division of the muscle fibers of the distal esophagus and proximal stomach—and a fundoplication, which is done by wrapping the fundus of the stomach around the lower esophagus to prevent postoperative gastroesophageal reflux. Surgery for gastroesophageal reflux disease and hiatal hernia involves performing a hiatoplasty or surgical repair of the esophageal hiatus of the diaphragm and a fundoplication. The aforementioned surgeries are performed through an abdominal approach. Transthoracic procedures for anti-reflux surgery and hiatal hernia repair have been reported but are rarely used in contemporary surgical practice. In this chapter, transabdominal procedures using the da Vinci Xi robotic platform are described.