[Laparoscopic modified Girard myotomy and fundoplication for achalasia]

The standard surgical treatment for esophageal achalasia is improvement of the passage combined with antireflux repair. This paper describes the techniques of the laparoscopic modified Girard myotomy and fundoplication for achalasia. The laparoscopic modified Girard myotomy and fundoplication were performed through five upper abdominal trocars. A 10 cm myotomy extended 8 cm above the gastroesophageal junction and 2 cm below the gastroesophageal junction using an electric J-hook. Transverse sutures were placed on each side of the lower myotomy. The gastric fundus was covered with the upper myotomy with several sutures. Twenty-three patients were treated using this method. Excellent results were achieved. The laparoscopic modified Girard myotomy and fundoplication appear to provide effective treatment of achalasia with minimal invasion and rapid rehabilitation.