[Heller's myotomy with fundoplication by endoscopic surgery]

Area of Science:

• Gastroenterology
• Surgical Innovation

Context:

• Achalasia is a rare esophageal motility disorder.
• Laparoscopic Heller myotomy is a standard treatment.
• Antireflux procedures are crucial for optimal outcomes.

Purpose:

• To evaluate the 5-year experience with laparoscopic Heller myotomy and antireflux techniques for achalasia.
• To compare the efficacy and safety of different antireflux procedures (Dor, Toupet, Nissen).

Summary:

• 14 achalasia patients underwent laparoscopic Heller myotomy with Dor (8), Toupet (4), or Nissen (2) fundoplication.
• Dor fundoplication resulted in shorter surgical times (130 min) and excellent outcomes (Visick grade I in 4/8 patients).
• Average hospital stay was 2.5 days with early oral feeding (1.5 days).

Impact:

• Heller myotomy with antireflux repair is the gold standard for achalasia.
• Dor fundoplication appears to be a simpler, safer, and more effective antireflux technique for achalasia treatment.