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Laparoscopic Stapled Cardioplasty for End-Stage Achalasia

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

The standard of care for achalasia is laparoscopic Heller’s cardiomyotomy. This procedure achieves satisfactory and long-standing results in over 85 % of patients. However, in 10–15 % of patients, esophageal function will progressively deteriorate, and up to 5 % will develop end-stage achalasia. Options in these difficult patients are limited, and include redo cardiomyotomy, repeat dilatation, and in severe cases, esophagectomy.

Methods

In this report, we describe an alternate approach, a cardioplasty, which was originally described by Heyrovsky in 1913.

Results

The development of an angulated stapling device now makes this operation feasible by a laparoscopic approach.

Conclusion

This report highlights our technique for laparoscopic cardioplasty in patients with end-stage achalasia.

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Authors and Affiliations

  1. Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia

    Ewen A. Griffiths, Peter G. Devitt, Glyn G. Jamieson, Jennifer C. Myers & Sarah K. Thompson

  2. Department of Surgery, Royal Adelaide Hospital, Level 5, Eleanor Harrald Building, Adelaide, South Australia, 5000, Australia

    Sarah K. Thompson

Authors
  1. Ewen A. Griffiths
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  2. Peter G. Devitt
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  3. Glyn G. Jamieson
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  4. Jennifer C. Myers
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  5. Sarah K. Thompson
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Correspondence to Sarah K. Thompson.

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Griffiths, E.A., Devitt, P.G., Jamieson, G.G. et al. Laparoscopic Stapled Cardioplasty for End-Stage Achalasia. J Gastrointest Surg 17, 997–1001 (2013). https://doi.org/10.1007/s11605-012-2111-3

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  • DOI: https://doi.org/10.1007/s11605-012-2111-3

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