Laparoscopic Heller Myotomy for Achalasia: Experience from a Single Referral Tertiary Center

Mirsharifi, Alireza; Abdehgah, Ali Ghorbani; Mirsharifi, Rasoul; Jafari, Mehdi; Fattah, Noor; Mikaeli, Javad; Soroush, Ahmad Reza

doi:10.15171/mejdd.2018.133

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…25 Laparoscopic Heller myotomy (LHM) with a partial fundoplication is the optimal surgical treatment of achalasia, with effective control of symptoms in 90 to 97 percent of patients. 26 This procedure will cut the circular muscle fibers running across the lower esophageal sphincter, leading to relaxation. LHM can potentially cause uncontrolled gastroesophageal reflux, so it typically pairs with an anti-reflux procedure such as Nissen, the posterior (Toupet), or the anterior (Dor) partial fundoplication.…”

Section: Uppermentioning

confidence: 99%

Achalasia in a Female Adolescent

Prasetyo¹,

Suryana²

2023

Cermin Dunia Kedokteran

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Achalasia is an esophageal smooth muscle motility disorder due to relaxation failure of the lower esophageal sphincter. This condition is rarely found in children; 2-5% cases occur in less than 16-year old. Case: A 16-year-old girl presented with chief complaint of regurgitation. She also complained of dysphagia, weight loss, and general weakness. Her general appearance was weak, underweight, and decreased skin turgor. Barium esophagogram demonstrated a narrowing of esophagus lumen distal to the esophagogastric junction with a “bird’s beak” appearance or rat tail sign. Esophageal achalasia was diagnosed and managed with open (laparotomy) surgical myotomy and fundoplication. Post-operative diet arrangement was carried out gradually and the patient was discharged 4 days post-surgery. Akalasia merupakan gangguan motilitas otot polos esofagus yang terjadi akibat kegagalan relaksasi lower esophageal sphincter (LES). Kondisi ini jarang ditemukan pada anak-anak; 2-5% kasus pada anak berusia di bawah 16 tahun. Kasus: Seorang remaja perempuan 16 tahun datang ke poliklinik bedah anak dengan keluhan utama regurgitasi. Anak juga mengeluh disfagia, penurunan berat badan, dan kelemahan umum. Keadaan umum anak lemah, berat badan rendah, dan penurunan turgor kulit. Esofagogram barium menunjukkan penyempitan lumen esofagus distal terhadap esophagogastric junction dengan tampakan “bird’s beak” atau tanda rat tail. Akalasia esofagus didiagnosis dan ditatalaksana dengan pembedahan laparotomi miotomi dan fundoplikasi. Pemulihan diet pasca-operasi secara perlahan dan pasien dipulangkan 4 hari pasca pembedahan

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Section: Uppermentioning

confidence: 99%

Achalasia in a Female Adolescent

Prasetyo¹,

Suryana²

2023

Cermin Dunia Kedokteran

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“…Achalasia is a primary oesophageal motor disorder thought to be caused by autoimmune neuro-degeneration of the oesophageal myenteric plexus. Achalasia is the most well known esophageal motility disorder 1 with an annual incidence of 1 in 100,000 and prevalence of 8 in 10,000 people. The prevalence is equal in men and women.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence is equal in men and women. 1 However, recent studies have shown that the incidence of achalasia is increasing, particularly in South America, and varies among countries. 2 Achalasia has a bimodal age distribution, with most patients aged between either 20-40 or 60-70 years.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Heller’s cardiomyotomy for achalasia cardia-a case series with review of literature

Agrawal,

Joshi

2024

Int Surg J

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Laparoscopic Heller’s cardio myotomy has almost completely replaced the open procedure performed for achalasia cardia. Several studies have suggested that long-term results with surgery for achalasia cardia are better than a medical line of management. In this retrospective study, we outline our experience with laparoscopic cardio myotomy over 15 years. Also, we compare our results with those of other interventional modalities which are known therapeutic options for achalasia cardia. We identified 10 patients (4 females and 6 males) operated upon by a single surgeon from 2008 to 2023, at our institution. The age range was 16-48 years. All patients had undergone oesophago-gastro-duodenoscopy (OGD scopy), upper gastro-intestinal (UGI) manometry and contrast enhanced computerised tomography (CECT) of the lower chest and upper abdomen. The patients were analysed for age, sex, symptoms, pre-operative evaluation, the exact procedure performed (Heller’s+Toupet’s vs Heller’s+Dorr’s), morbidity/mortality and functional outcomes. They were also reviewed to examine the length of stay, length of procedure, complications and recurrent symptoms on follow-up.

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“…The treatment of achalasia is not curative. It is a progressive disease that leads patients to seek symptom palliation, which can be accomplished by reducing the resting and swallow-induced pressures of the LES [1,3,[7][8][9][10] . That is, therapy is aimed at relieving the functional obstruction.…”

Section: Introductionmentioning

confidence: 99%

“…In comparison, minimally invasive Heller myotomy is currently the gold standard surgical approach for achalasia as it has the best long-term outcome. Although per-oral endoscopic myotomy (POEM) and robotic Heller myotomy (RHM) are increasingly being used, laparoscopic Heller myotomy (LHM) is the longest practiced surgical approach with safe and effective outcomes [8,9,[12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Robotic Heller myotomy

Sollie¹,

Jiwani²,

Wei³

2020

Mini-invasive Surg

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Achalasia is a neurodegenerative disorder of the esophagus of unknown etiology, which affects motility, causing symptoms such as progressive dysphagia with liquids then solids, heartburn, regurgitation, odynophagia, weight loss, nocturnal cough, and chest pain. Evaluation will show a characteristic "bird's beak" appearance on barium esophagram and diagnosis is confirmed with esophageal manometry. Durable relief from the symptoms of achalasia can be achieved with pneumatic dilation, per-oral endoscopic myotomy, or surgical myotomy. Laparoscopic Heller myotomy with Dor (or Toupet) fundoplication for many years had been considered the gold standard for therapy. Since its development in 2001, the robotic Heller myotomy (RHM) has gained increasing popularity. Studies have shown equivalent efficacy of relieving achalasia symptoms but decreased incidence of esophageal perforation with RHM. The higher cost of RHM remains the largest barrier. Our objective was to provide a brief review of the current literature related to RHM and provide a detailed description of how to perform the procedure.

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Laparoscopic Heller Myotomy for Achalasia: Experience from a Single Referral Tertiary Center

Cited by 5 publications

References 20 publications

Achalasia in a Female Adolescent

Achalasia in a Female Adolescent

Laparoscopic Heller’s cardiomyotomy for achalasia cardia-a case series with review of literature

Robotic Heller myotomy

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