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Updated: Aug 16, 2026
Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
The laparoscopic reoperation of failed Heller myotomy
P E Duffy1, Z T Awad, C J Filipi
1Department of Surgery, Suite 3740, Creighton University Medical Center, 601 North 30th Street, Omaha, NE 68131, USA.
Background:
Laparoscopic Heller myotomy for achalasia has a 10-20% failure rate and may require reoperation to control persistent, or recurrent symptoms of dysphagia. We report our experience with laparoscopic reoperation for failed Heller myotomy.
Methods:
Between 1996 and 2001, 5 patients underwent reoperative laparoscopic Heller myotomy. The mean age was 39 years. The presenting symptoms were persistent dysphagia ( n = 3), recurrent dysphagia ( n = 1), and weight loss ( n = 1). The mean duration between 1st surgery and recurrence of symptoms was 2 months and the mean duration between surgeries was 27.5 months. All operations were completed laparoscopically.
Results:
There were no intraoperative or postoperative complications. Incomplete gastric myotomy was the cause of all 5 primary surgical failures. The mean hospital stay was 2 days. Mean follow-up was 12.8 months. Results were excellent in 2 patients who reported no dysphagia postoperatively (dysphagia grade 0) and good in 3 patients (60%) who all reported improvement in swallowing (dysphagia grade I-II).
Conclusion:
Laparoscopic reoperation for failed Heller myotomy is feasible with encouraging preliminary results.
