This disease process is characterized by the inability to swallow due to a weak esophageal muscle and/or a too tight gastric inlet. Non surgical treatment options are drugs that relax the gastric inlet, balloon dilatation of the gastric inlet or injection of botulin toxin to paralyze the muscle and decrease the pressure. Surgical options that have been proven to have the most prolonged beneficial effects are the muscle splitting technique (Heller's Myotomy).
Hospital Stay: 24 Hours
Type of Anesthesia: General
Operative Time: 90 minutes
Possible Complications: Bleeding, Infection, Recurrence, Esophageal Perforation, Heartburn
Pictures of the Operative Technique
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Figure 1. Positioning of the patient and team. Patient in lithotomy position.
ANS, Anesthetist; S, surgeon; A1, A2, assistants; N, nurse; M, monitor |
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Figure 2. Trocar sites and instrumentation |
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Figure 3. Dissection of avascular plane |
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Figure 4. Dissection of left and right crura |
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Figure 5. Transected short gastric vessels |
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Figure 6. Anterior seromyotomy |
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Figure 7. First layer of gastric fundoplication |
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Figure 8. Second layer of gastric fundoplication |
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Figure 9. Completed myotomy with fundoplication |
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