V-03. Cardioplasty + Roux-en-Y Gastroplasty (Modified Serra-Dória) for Recurrent Type I Achalasia Correction

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ID: 325922
2026
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Ranked #237 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Benign Disease: Esophageal Surgery Background Esophageal achalasia is a primary esophageal motility disorder characterized by the failure of the lower esophageal sphincter (LES) to relax and the absence of coordinated peristalsis, leading to progressive dysphagia, regurgitation, and weight loss. Type I achalasia, manometrically defined by a complete absence of esophageal peristalsis (100% failed contractions) and lack of pressurization in the esophageal body, with no relaxation of the LES, food stasis and marked esophageal dilation. In this challenging context, the Serra-Dória surgery, proposed in 1970, emerges as a vital therapeutic alternative for complex cases, combining Gröndhal's cardioplasty, subtotal gastrectomy with antrectomy, and Roux-en-Y jejunojejunostomy. Conclusion This video exemplifies an effective and safe surgical approach for refractory achalasia in obese patients. The role of the modified Serra-Dória surgery is highlighted as a functional and safe alternative following the failure of multiple previous procedures. Video Description We present the case of a 51-year-old obese female patient (BMI 41) with a history of type I achalasia previously treated with cardiomyotomy and partial fundoplication (2011), in addition to two pneumatic dilatations (2021 and 2023). She experienced recurrence of symptoms (progressive dysphagia, regurgitation, chest pain, and bloating, without weight loss). Esophageal manometry confirmed refractory type I achalasia. Given her obesity and the failure of prior therapies, a re-approach of the esophageal hiatus and the modified Serra-Dória procedure were indicated. The surgery was performed laparoscopically, with esophagogastric anastomosis using a linear stapler. Digestive reconstruction followed the principles of Roux-en-Y gastroplasty: gastrectomy of the gastric body, gastrojejunal, and enteroenteric anastomoses. The patient showed good postoperative evolution, with early hospital discharge, no dysphagia or complications, and a weight loss of 7 kg in the first postoperative month.
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Authors Edno Tales Bianchi, Ricardo Purchio Galletti, Gustavo Gomes Quintas, Sérgio Szachnowicz, Rubens Antônio Aissar Sallum, Ulysses jr Ribeiro, Paulo Herman
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.403
URL
https://academic.oup.com/dote/article-pdf/39/Supplement_1/doag077.403/70761090/doag077.403.pdf
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