Laparoscopic Heller myotomy is a minimally invasive procedure that opens the tight lower esophageal sphincter (the valve between the esophagus and the stomach) by performing a myotomy (cutting the thick muscle of the lower part of the esophagus and the upper part of the stomach) to relieve the dysphagia (difficulty swallowing).
Heller’s Myotomy is the surgery used to treat Achalasia Cardia. Achalasia is a rare disorder in which your esophagus is unable to move food and liquids down into your stomach. Your esophagus is the muscular tube that transports food from your mouth to your stomach. At the area where your esophagus meets your stomach is a ring of muscle called the lower esophageal sphincter (LES). This muscle relaxes (opens) to allow food to enter your stomach and contracts (tightens to close) to prevent stomach content from backing up into your esophagus. If you have achalasia, the LES doesn’t relax, which prevents food from moving into your stomach. The surgeon cuts the muscle at the lower end of the esophageal sphincter to allow food to pass more easily into the stomach.
Five small incisions are made in the abdomen to allow insertion of a camera and working surgical instruments.For the myotomy (cutting the muscle), the lower part of the esophagus and the upper part of the stomach are exposed and marked to accurately identify the location of the lower esophageal sphincter.The myotomy includes cutting of the muscular layer of the lower part of the esophagus and the upper part of the stomach to completely open the lower esophageal sphincter and relieve dysphagia.To prevent reflux from the stomach into the esophagus, a Dor fundoplication is performed by partially wrapping the stomach around the esophagus. The fundoplication covers the myotomy and makes a low pressure valve.
Patients stay in the hospital for one night. They start drinking one day after surgery and are discharged home. They will follow dietary restrictions for about two weeks and can start advancing their diet after a clinic visit two weeks following the surgery.
The laparoscopic procedure has several benefits: