Robotic Cricopharyngeal Myotomy in the Treatment of Cricopharyngeal Bars

Document Type

Conference Proceeding

Publication Date

4-2025

Publication Title

Surgical Endoscopy

Abstract

Introduction: Failure of the cricopharyngeus to relax results in oropharyngeal dysphagia, which over time results in hypertrophy and increased risk for aspiration. Open myotomy is one definitive treatment option, however there are several drawbacks attributable to the long neck incision, ± 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 cricopharyngeal myotomy, which has never been described before prior to our original dataset.

Methods: Consecutive robotic cricopharyngeal myotomies performed in adult patients by a single surgeon from August 2021 to March 2024 were retrospectively reviewed. 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 cricopharyngeal 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 that were identified. All patients were started on full liquids in recovery prior to discharge. Same-day discharge rate was 88%. Symptom resolution was reported in 23/24 patients (95.8%) who completed postoperative follow-up. There was one postoperative complication (delayed wound hematoma) but no readmissions. Two instances of recurrence were reported (one with recurrent cricopharyngeal bar and one with symptoms only).

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

Volume

39

Issue

Suppl 1

First Page

S54

Last Page

S54

Comments

SAGES Annual Meeting, March 12–15, 2025, Long Beach, CA

DOI

10.1007/s00464-025-11688-3

ISSN

1432-2218

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