Laparoscopic Heller myotomy in surgical treatment of achalasia

Abstract

Purpose: The aim of this study was to evaluate the general properties, surgical techniques and complications of laparoscopic Heller myotomy in surgical treatment of achalasia including our clinical experience.

Patients and Methods: Eight patients who underwent laparoscopic Heller myotomy in Ministry of Health Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital 3rd General Surgery Clinic between May 1999 and December 2004 were examined retrospectively.

Results: Six female and two male patients were included in this study. The mean age was 42.33 (range 19-57). All patients had dysphagia and all had increased lower osephageal resting pressure. Six patients were treated by laparoscopic Heller myotomy, other two patients were treated by laparoscopic Heller myotomy adding Toupet anti reflux procedure. There was no conversion to open surgery. Mucosal perforation occurred in one patient and it was treated by laparoscopic suturing techniques. The mean operation time was 95 minutes (range 56-160). Oral liquid food intake was allowed on the second day of the operation. The mean duration of hospital stay was 3.2 days (range 2-5).

Conclusion: Laparoscopic surgery and laparoscopic Heller myotomy is a more preferable and effective procedure in surgical treatment of achalasia because of reduced duration of hospital stay, increased patient comfort during the surgical procedure, improved cosmetic results and gives patient early return to normal activity and social life .