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Author Spotlight: Cutting-Edge Robotic Heller Myotomy Protocol for Treatment of Achalasia
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Author Spotlight: Cutting-Edge Robotic Heller Myotomy Protocol for Treatment of Achalasia

Published on: February 16, 2024

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Laparoscopic Heller Myotomy for Achalasia: Experience from a Single Referral Tertiary Center

Alireza Mirsharifi1, Ali Ghorbani Abdehgah2, Rasoul Mirsharifi3

  • 1Tehran University of Medical Sciences, Department of General Surgery, Shariati Hospital, Tehran, Iran.

Middle East Journal of Digestive Diseases
|August 6, 2019
PubMed

Insights

Laparoscopic Heller myotomy (LHM) is a safe and effective treatment for achalasia, significantly improving symptoms like dysphagia and chest pain. This procedure offers good outcomes, even for patients with prior endoscopic interventions.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Esophageal Motility Disorders

Background:

  • Achalasia is a primary esophageal motility disorder.
  • Laparoscopic Heller myotomy (LHM) is recognized as a highly effective treatment for achalasia.
  • This study reviews outcomes of LHM performed at our institution.

Purpose of the Study:

  • To evaluate the efficacy and safety of Laparoscopic Heller myotomy (LHM) for achalasia treatment.
  • To assess symptom improvement and complication rates following LHM with fundoplication.
  • To analyze the impact of LHM on specific achalasia symptoms.

Main Methods:

  • A cross-sectional study of 36 consecutive patients undergoing LHM between 2015 and 2017.
  • LHM was performed followed by either Toupet (anterior) or Dor (posterior) partial fundoplication.
  • Patients were followed for at least six months, with symptom assessment using the Eckardt Symptom Scoring (ESS).

Main Results:

  • Symptom improvement was observed in 74.2% of patients based on ESS.
  • Significant improvements were noted in regurgitation, retrosternal pain, dysphagia, and weight loss (p < 0.05).
  • Post-operative reflux occurred in 30.6% of patients; no serious complications were reported.

Conclusions:

  • Laparoscopic Heller myotomy (LHM) combined with partial fundoplication is a safe and effective treatment for achalasia.
  • The procedure yields good outcomes, particularly for patients refractory to other treatments.
  • LHM demonstrates a favorable safety profile, even in patients with a history of endoscopic interventions.

Keywords:
AchalasiaBotulinum toxinComplicationHeller myotomyLaparoscopyTertiary center

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