Background

Obesity and achalasia are different pathologies that sometimes may coexist, and both conditions mustbe treated individually. We present a 40-year-old female with severe obesity (BMI 48), who presented tothe bariatric surgery department. Her past medical history is remarkable for achalasia, treated withHeller myotomy in 2018 in another institution. A preoperative EGD showed thickening and distention ofthe distal esophagus along with contrast retention, signs that were compatible with achalasiarecurrence. The decision was to perform a robotic Roux-en-Y gastric bypass along with a redo of theHeller Myotomy. The procedure was well tolerated, and no signs of immediate postoperativecomplications were present. Follow up at 6 months after surgery showed a BMI of 36 and no symptomsof GERD or dysphagia. At 12 months postoperative, the patient remained asymptomatic and with a BMIof 34