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). Further, a Dor fundoplication (a partial wrapping of the stomach around the esophagus to make a low-pressure valve) is performed to prevent reflux from the stomach into the esophagus following the myotomy. There is a very small chance that patients may develop reflux despite Dor fundoplication and may need to be treated with antacid medication. This procedure results in a great symptomatic relief.

Laparoscopic Heller Myotomy Procedure

The steps of the operation are the following:

Step 1

Laparoscopic Heller Myotomy Procedure
Five small incisions are made in the abdomen to allow insertion of a camera and working surgical instruments.

Step 2

Laparoscopic Heller Myotomy Procedure
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.

Step 3

Laparoscopic Heller Myotomy Procedure
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.

Step 4

Laparoscopic Heller Myotomy Procedure
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.

Laparoscopic Heller Myotomy Recovery

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.

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