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An improved laparoscopic technique for myotomy and fundoplication in patients with achalasia

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Summary

Background

Achalasia is preferentially treated by esophageal myotomy. We present a potentially more secure technique of myotomy and fundoplication incorporating a three-stitch cardiopexy on the right of the esophagus and a left lateral fixation at the angle of His.

Method

The process of dissection, fixation and repair is described in detail using intraoperative photographs to illustrate each step.

Conclusion

This technique is especially suited to achalasia patients with abnormalities of the hiatal anatomy.

This paper offers an improvement to a well-practiced technique, which is presented in significant detail. It is of particular interest as it may improve outcomes for achalasia treatment thanks to a more secure technique.

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References

  1. Chino O, Makuuchi H, Ozawa S, et al. Multiple early carcinomas of the esophagus associated with achalasia treated by endoscopic submucosal dissection. Ann Cancer Res Ther. 2014;22(1):1–5.

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Authors and Affiliations

  1. Sydney Adventist Hospital, Wahroonga, NSW, Australia

    Trevor J. D’Netto MBBS (Hons)

  2. Concord Repatriation General Hospital, Concord, NSW, Australia

    Gregory L. Falk MBBS FRACS FACS

  3. Lindfield General Surgery, 29/12 Tryon Road, Lindfield, NSW, Australia

    Gregory L. Falk MBBS FRACS FACS & Sophia C. Little B. AVBS (Hons I)

Authors
  1. Trevor J. D’Netto MBBS (Hons)
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  2. Gregory L. Falk MBBS FRACS FACS
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  3. Sophia C. Little B. AVBS (Hons I)
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Corresponding author

Correspondence to Gregory L. Falk MBBS FRACS FACS.

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Conflict of interest

T.J. D’Netto, G.L. Falk, and S.C. Little declare that they have no competing interests.

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D’Netto, T.J., Falk, G.L. & Little, S.C. An improved laparoscopic technique for myotomy and fundoplication in patients with achalasia. Eur Surg 50, 4–7 (2018). https://doi.org/10.1007/s10353-017-0510-0

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  • DOI: https://doi.org/10.1007/s10353-017-0510-0

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