Laparoscopic Heller's myotomy for treatment ofachalasia in the Caribbean

The aim of this study is to examine the effectiveness with which Heller's myotomy can be performed laparoscopically in a Caribbean setting as a treatment for achalasia. Sixteen consecutive patients treated by the same surgeon were studied. Postoperative questionnaires that assessed symptomatology, complications and overall patient satisfaction with the procedure were utilized. The mean length of myotomy was 6 cm and none was converted to an open procedure. The mean age of the eleven female and five male patients was 38.4 years. The mean duration of follow-up was 16.7 months. Symptoms showed an overall 71.2% improvement postoperatively (p < 0.001). Fifteen patients reported being satisfied with their operation with only one being dissatisfied Intra-operative complications occurred in three patients. Estimated blood-loss (EBL) was minimal in each case. Intra- and postoperative mortality was zero. Laparoscopic Heller's myotomy can be effectively performed in local settings and should be considered as an alternative to the open approach in the treatment of all surgically-fit achalasia patients.