Heller Myotomy

Achalasia Treatment with Heller Myotomy

Achalasia is an inherited condition where the esophagus loses its ability to squeeze and propel food into the stomach, and the lower esophageal sphincter loses its ability to relax and allow food to enter the stomach. These two things – a nonfunctional esophagus and a tight lower esophageal sphincter – cause profound difficulty swallowing (dysphagia) that worsens with time.  Achalasia usually begins as difficulty swallowing solid foods, then progresses to include difficulty with liquids, and can even progress to such a severe degree as to require an esophagectomy.

The goal of surgery for achalasia is to restore the ability to swallow without difficulty, while minimizing the risk of severe GERD. There is no cure for achalasia, but the outcomes after surgery are fantastic. There are currently several endoscopic options for the treatment of achalasia as well, and these are typically performed by a gastroenterologist. While endoscopic options are less invasive, they are associated with a higher risk of severe GERD and cannot fix any associated hiatal hernia. Therefore, surgery is the option of choice for most patients.

Laparoscopic Heller Myotomy

A Laparoscopic Heller Myotomy procedure can correct achalasia. This operation has two components, both of which are performed laparoscopically. First, the surgeon performs a Heller Myotomy, where the muscles of the esophagus are divided to “open up” the lower esophageal sphincter and allow food to pass. Second, a partial fundoplication is performed to prevent GERD.

Achalasia patients will undergo testing to determine the ability of the esophagus to move food and for the lower esophageal sphincter to relax to allow food to pass. The procedure generally takes one to two hours and requires just one night in the hospital. Patients then slowly progress from liquids to solid foods over the course of several weeks. The outcomes are truly excellent.  Our team can explain the benefits, risks, and care plan for the Heller Myotomy during a surgical consultation.

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