Background
59-year-old female with BMI of 46 and comorbidities including type II diabetes, COPD, and hypertension was found to have achalasia. She then underwent a robotic assisted Heller myotomy with intraoperative impedance planimetry as well as hiatal hernia repair and roux en y gastric bypass. She progressed well postoperatively and was discharged home. She followed up for a 10-day day postoperative visit and had no issues with swallowing, was no longer using insulin for her T2DM, and had lost 15 lbs.