Introduction: Recurrence of achalasia may occur in 10%-20% of cases operated by Heller's cardiomyotomy. Most of these patients will require further surgery to relieve symptoms. Major technical difficulties can be found in these reoperations.
Case report: A 50-year-old female patient with relapsed idiopathic achalasia after Heller's technique was treated with an unusual procedure, for the first time in the literature, by minimally invasive access with robotic assistance.
Conclusions: The Serra-Doria operation allows preserving the esophagus and alleviating dysphagic symptoms with low rates of postoperative complications. The use of robotic technology is perfectly feasible and allows minimally invasive access in complex cases and reoperations.
Keywords: Grondhal's cardioplasty; Serra-Doria operation; cardiomyotomy; recurrent achalasia.