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Effectiveness of Laparoscopic Heller's Myotomy in Achalasia
General Surgery / Jul 14th, 2019 2:24 pm     A+ | a-


Oesophageal Achalasia is a functional disorder of the characterized by loss of coordinated peristalsis and lack of lower esophageal sphincter relaxation. The main patient's symptoms include dysphagia and chest pain. The classic diagnostic presentation is a “bird’s beak” deformity on the barium swallow study. Upper GI endoscopy and manometry are usually performed in the diagnostic workup, the later indicating a lack of normal peristalsis and incomplete LES relaxation.

Laparoscopic Hellers Myotomy

The laparoscopic Heller myotomy offers 95-100% resolution of symptoms at 5 years, and 75% at 15 years. It carries a 6.3% risk of complications and a 0.1% risk of mortality.  To perform laparoscopic Heller's myotomy the gastroesophageal junction is identified, and this area can be exposed with caudal retraction on the gastroesophageal fat pad.  A monopolar hook cautery or ultrasonic device is then used to divide the outer, longitudinal muscle fibers of the esophagus on its right anterolateral surface.  To perform laparoscopic Heller's myotomy many surgeons will use concomitant upper endoscopy to visualize the high-pressure zone during the division of the esophageal muscle layer; under this direct visualization, the circular fibers can be divided.  This dissection is taken 2-3 cm onto the stomach carefully.  An air leak test can then be performed. After myotomy, Dor Fundoplication has to be performed as an antireflux procedure following esophagogastric myotomy.  Division of short gastric vessels to facilitate fundoplication is at the discretion of the surgeon.
10 COMMENTS
meddco healthcare
#1
Dec 19th, 2019 9:39 am
you are sharing the best blog its very informative.
Savita
#2
Apr 24th, 2020 1:43 pm
I love your techniques. Very helpful and excellent video quality. Thanks for sharing laparoscopic Heller myotomy Video.
Ravi kant
#3
Apr 24th, 2020 1:47 pm
I learned a lot from your lecture. The lectures were very practical and usable in practice. Thanks
Dr. Sanjay Shrivastav
#4
Apr 24th, 2020 1:52 pm
Thanks for the great lectures. You do not know you have changed my life! Thanks for sharing this video.
Dr Nitish Kumar Yadav
#5
May 11th, 2020 9:53 am
Bless you sir your kindness and your hard work, deserve medals, Thank you so much sir your surgical skills displayed in this video……
Dilara
#6
May 13th, 2020 11:53 am
Dr. R.K. Mishra is perfect in his explanations and demonstrations of the techniques. He's far far better than any other Laparoscopic surgeon's. I'm very grateful for these video of laparoscopic Heller myotomy. Thanks for sharing this video.
AMIT KUMAR
#7
May 21st, 2020 10:32 am
This is the best explanation i have ever seen the video of Effectiveness of Laparoscopic Heller's Myotomy in Achalasia. You're an amazing Teacher !!!! God bless you. Thank you sooo much for this video.
Dr. Shailesh Tyagi
#8
May 22nd, 2020 11:36 am
I love your techniques. Very helpful and excellent video quality. Thanks for sharing Effectiveness of Laparoscopic Heller's Myotomy in Achalasia.
Dr. Sharique Ahmed
#9
Jun 13th, 2020 11:12 am
Dr. R. K. Mishra is perfect in his explanations and demonstrations of the techniques. He's far better than any of my instructors. I'm very grateful for these videos.
Dr. Ronald Aanald
#10
Jun 13th, 2020 11:37 am
Excellent video presentation of Effectiveness of Laparoscopic Heller's Myotomy in Achalasia. Amazing techniques i have ever watched. Thanks for sharing. Great technique and teaching! Best presentation in the world does not get any more simplified than this..
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