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Updated: Jun 4, 2026
Robotic Heller Myotomy for Advancements in Surgical Management of Achalasia
Published on: February 16, 2024
Heller's cardiomyotomy with augmented Toupet's fundoplication immediate and long-term outcome
Bandhuphat Chakrabandhu1, Sirikarn Yamada, Thiraphat Chakrabandhu
1Gastrointestinal Surgery Unit, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand. namtaow@hotmail.com
Insights
Open Heller cardiomyotomy with Toupet's fundoplication effectively treats achalasia, showing excellent short-term and long-term outcomes in Thai patients. This surgical approach for achalasia provides significant symptom relief.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Digestive System Surgery
Background:
- Previous studies indicate excellent results for Heller cardiomyotomy with Toupet's fundoplication.
- The efficacy of the open surgical technique in Thai achalasia patients remains underreported.
Purpose of the Study:
- To evaluate the immediate and long-term outcomes of open transabdominal Heller cardiomyotomy with Toupet's fundoplication for achalasia.
- To provide data on this surgical treatment for achalasia in the Thai population.
Main Methods:
- A retrospective review of achalasia patients undergoing open Heller cardiomyotomy with Toupet's fundoplication.
- Data collected from Maharaj Nakorn Chiang Mai Hospital, Thailand, between 1997 and 2007.
- Descriptive statistical analysis of patient data.
Main Results:
- Twenty-two achalasia patients (11 male, mean age 40) were analyzed.
- 91% of patients experienced immediate dysphagia relief post-surgery.
- No early postoperative complications were observed; 14% experienced symptom relapse over a mean 30-month follow-up.
Conclusions:
- Open transabdominal Heller's cardiomyotomy with Toupet's fundoplication is an effective treatment for achalasia.
- Experienced surgeons can achieve positive outcomes with this technique in Thai achalasia patients.
- This study confirms the efficacy of the procedure in a local context.
Background:
Achalasia patients who underwent Heller cardiomyotomy with Toupet's fundoplication have excellent results in a previous report data. However, the result with open technique has not been reported in Thai.
Objective:
To study the immediate and long-term outcome of open transabdominal Heller cardiomyotomy with Toupet's fundoplication in Achalasia patients.
Material And Method:
Retrospective review of all achalasia patients who underwent open Heller cardiomyotomy with Toupet's fundoplication in Maharaj Nakorn Chiang Mai Hospital, Thailand during the past ten years (1997-2007). The data was analysis with descriptive statistics.
Results:
Twenty-two cases (11 male) were included in this study. Mean age was 40 years. The mean duration of symptoms before surgery was 62.5 months. Ninety-one percent of patients were free from dysphagia immediately after operation. There was no early postoperative complication. Three patients had relapse symptom (14%). Mean follow-up time in the present study was 30 months.
Conclusion:
Open transabdominal Heller's cardiomyotomy with augmented Toupet's fundoplication done by experienced surgeons is an effective technique to treat achalasia patients in our center.
