[Laparoscopic surgery for esophageal achalasia]

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery

Context:

• Esophageal achalasia management has evolved, with surgery becoming a primary treatment.
• Laparoscopic Heller myotomy and Dor fundoplication is now the preferred surgical approach.

Purpose:

• To evaluate the efficacy and safety of laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia.
• To identify key technical aspects for successful laparoscopic Heller myotomy and Dor fundoplication.

Summary:

• The laparoscopic Heller and Dor operation was successfully performed on 22 patients with esophageal achalasia, all experiencing uneventful postoperative courses.
• Manometric, endoscopic, and pH monitoring evaluations demonstrated favorable outcomes.
• Six critical technical elements contribute to the procedure's success: flexible laparoscopy, pneumoperitoneum, gauze use, specialized shears, and advanced knot-tying techniques.

Impact:

• Laparoscopic Heller myotomy and Dor fundoplication is an ideal, minimally invasive treatment for esophageal achalasia.
• The procedure is indicated for patients unresponsive to medical therapy, pneumatic dilatation, or those with nocturnal aspiration.
• Experienced surgeons can achieve excellent results with this approach, improving patient outcomes.