Skip to main content
Top
Published in: Journal of Gastrointestinal Surgery 9/2008

01-09-2008 | how i do it

Laparoscopic Heller Myotomy: Technical Aspects and Operative Pitfalls

Authors: Khashayar Vaziri, Nathaniel J. Soper

Published in: Journal of Gastrointestinal Surgery | Issue 9/2008

Login to get access

Abstract

Achalasia is a rare motor disorder of the esophagus characterized by aperistalsis and impaired relaxation of the lower esophageal sphincter (LES). The etiology of this disease remains unknown. The current treatment is palliative and relies upon surgical disruption of the fibers of the LES. The technical aspects and operative pitfalls of laparoscopic Heller myotomy are described in this article.
Literature
1.
go back to reference Lendrum F. Anatomic features of the cardiac orifice of the stomach with special reference to cardiospasm. Arch Intern Med 1937;59:474–476. Lendrum F. Anatomic features of the cardiac orifice of the stomach with special reference to cardiospasm. Arch Intern Med 1937;59:474–476.
2.
go back to reference Vaezi MF, et al. Botulinum toxin versus pneumatic dilatation in the treatment of achalasia: a randomised trial. Gut 1999;44(2):231–239.PubMedCrossRef Vaezi MF, et al. Botulinum toxin versus pneumatic dilatation in the treatment of achalasia: a randomised trial. Gut 1999;44(2):231–239.PubMedCrossRef
3.
go back to reference Zaninotto G, et al. Randomized controlled trial of botulinum toxin versus laparoscopic heller myotomy for esophageal achalasia (see comment). Ann Surg 2004;239(3):364–370.PubMedCrossRef Zaninotto G, et al. Randomized controlled trial of botulinum toxin versus laparoscopic heller myotomy for esophageal achalasia (see comment). Ann Surg 2004;239(3):364–370.PubMedCrossRef
4.
go back to reference Csendes A, et al. Late results of a prospective randomised study comparing forceful dilatation and oesophagomyotomy in patients with achalasia. Gut 1989;30(3):299–304.PubMedCrossRef Csendes A, et al. Late results of a prospective randomised study comparing forceful dilatation and oesophagomyotomy in patients with achalasia. Gut 1989;30(3):299–304.PubMedCrossRef
5.
go back to reference Burpee SE, et al. Objective analysis of gastroesophageal reflux after laparoscopic heller myotomy: an anti-reflux procedure is required. Surg Endosc 2005;19(1):9–14.PubMedCrossRef Burpee SE, et al. Objective analysis of gastroesophageal reflux after laparoscopic heller myotomy: an anti-reflux procedure is required. Surg Endosc 2005;19(1):9–14.PubMedCrossRef
6.
go back to reference Richards WO, et al. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial.[see comment]. Ann Surg 2004;240(3):405–412. discussion 412–5.PubMedCrossRef Richards WO, et al. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial.[see comment]. Ann Surg 2004;240(3):405–412. discussion 412–5.PubMedCrossRef
7.
go back to reference Bessell JR, et al. Laparoscopic cardiomyotomy for achalasia: long-term outcomes. AN Z J Surg 2006;76(7):558–562.CrossRef Bessell JR, et al. Laparoscopic cardiomyotomy for achalasia: long-term outcomes. AN Z J Surg 2006;76(7):558–562.CrossRef
8.
go back to reference Csendes A, et al. Very late results of esophagomyotomy for patients with achalasia: clinical, endoscopic, histologic, manometric, and acid reflux studies in 67 patients for a mean follow-up of 190 months. Ann Surg 2006;243(2):196–203.PubMedCrossRef Csendes A, et al. Very late results of esophagomyotomy for patients with achalasia: clinical, endoscopic, histologic, manometric, and acid reflux studies in 67 patients for a mean follow-up of 190 months. Ann Surg 2006;243(2):196–203.PubMedCrossRef
9.
go back to reference Jeansonne LO, et al. Ten-year follow-up of laparoscopic Heller myotomy for achalasia shows durability. Surg Endosc 2007;21(9):1498–1502.PubMedCrossRef Jeansonne LO, et al. Ten-year follow-up of laparoscopic Heller myotomy for achalasia shows durability. Surg Endosc 2007;21(9):1498–1502.PubMedCrossRef
10.
go back to reference Perrone JM, et al. Results of laparoscopic Heller–Toupet operation for achalasia. Surg Endosc 2004;18(11):1565–1571.PubMed Perrone JM, et al. Results of laparoscopic Heller–Toupet operation for achalasia. Surg Endosc 2004;18(11):1565–1571.PubMed
11.
go back to reference Wright AS, et al. Long-term outcomes confirm the superior efficacy of extended Heller myotomy with Toupet fundoplication for achalasia. Surg Endosc 2007;21(5):713–718.PubMedCrossRef Wright AS, et al. Long-term outcomes confirm the superior efficacy of extended Heller myotomy with Toupet fundoplication for achalasia. Surg Endosc 2007;21(5):713–718.PubMedCrossRef
12.
go back to reference Deb S, et al. Laparoscopic esophageal myotomy for achalasia: factors affecting functional results. Ann Thorac Surg 2005;80(4):1191–1194. discussion 1194–5.PubMedCrossRef Deb S, et al. Laparoscopic esophageal myotomy for achalasia: factors affecting functional results. Ann Thorac Surg 2005;80(4):1191–1194. discussion 1194–5.PubMedCrossRef
13.
go back to reference Smith CD, et al. Endoscopic therapy for achalasia before Heller myotomy results in worse outcomes than heller myotomy alone. Ann Surg 2006;243(5):579–584. discussion 584–6.PubMedCrossRef Smith CD, et al. Endoscopic therapy for achalasia before Heller myotomy results in worse outcomes than heller myotomy alone. Ann Surg 2006;243(5):579–584. discussion 584–6.PubMedCrossRef
14.
go back to reference Hunter JG, et al. Laparoscopic Heller myotomy and fundoplication for achalasia. Ann Surg 1997;225(6):655–664. discussion 664–5.PubMedCrossRef Hunter JG, et al. Laparoscopic Heller myotomy and fundoplication for achalasia. Ann Surg 1997;225(6):655–664. discussion 664–5.PubMedCrossRef
15.
go back to reference Spiess AE, Kahrilas PJ. Treating achalasia: from whalebone to laparoscope. JAMA 1998;280(7):638–642.PubMedCrossRef Spiess AE, Kahrilas PJ. Treating achalasia: from whalebone to laparoscope. JAMA 1998;280(7):638–642.PubMedCrossRef
Metadata
Title
Laparoscopic Heller Myotomy: Technical Aspects and Operative Pitfalls
Authors
Khashayar Vaziri
Nathaniel J. Soper
Publication date
01-09-2008
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 9/2008
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-008-0475-1

Other articles of this Issue 9/2008

Journal of Gastrointestinal Surgery 9/2008 Go to the issue