Laparoscopic Heller Myotomy with Partial (Dor) Fundoplication

  • Francisco Schlottmann
  • Marco Di Corpo
  • Marco G. Patti


Achalasia is a primary esophageal motility disorder characterized by lack of esophageal peristalsis and partial or absent relaxation of the lower esophageal sphincter in response to swallowing. Patients’ symptoms include dysphagia, regurgitation, aspiration, heartburn, and chest pain. This chronic disease has no cure, and the different treatment modalities aim to improve esophageal emptying and provide symptomatic relief. The laparoscopic Heller myotomy includes an esophageal myotomy, which is extended proximally for about 6 cm above the esophagogastric junction, and distally for about 2.5 cm onto the gastric wall. A partial fundoplication is added in order to prevent postoperative gastroesophageal reflux. A properly executed technique is critical for the success of the operation.


Achalasia Dysphagia Laparoscopy Heller myotomy Dor fundoplication 


Conflict of Interest

The authors have no conflict of interest to declare.


  1. 1.
    Schlottmann F, Patti MG. Esophageal achalasia: current diagnosis and treatment. Expert Rev Gastroenterol Hepatol. 2018;12(7):711–21.CrossRefGoogle Scholar
  2. 2.
    Schlottmann F, Neto RML, Herbella FAM, Patti MG. Esophageal achalasia: pathophysiology, clinical presentation, and diagnostic evaluation. Am Surg. 2018;84(4):467–72.PubMedGoogle Scholar
  3. 3.
    Oelschlager BK, Chang L, Pellegrini CA. Improved outcome after extended gastric myotomy for achalasia. Arch Surg. 2003;138(5):490–5.CrossRefGoogle Scholar
  4. 4.
    Rawlings A, Soper NJ, Oelschlager B, et al. Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia: results of a multicenter, prospective, randomized-controlled trial. Surg Endosc. 2012;26(1):18–26.CrossRefGoogle Scholar
  5. 5.
    Kumagai K, Kjellin A, Tsai JA, et al. Toupet versus Dor as a procedure to prevent reflux after cardiomyotomy for achalasia: results of a randomised clinical trial. Int J Surg. 2014;12(7):673–80.CrossRefGoogle Scholar
  6. 6.
    Borraez B, Ramirez M, Patti MG. Patient positioning. In: Fisichella PM, Patti MG, editors. Atlas of esophageal surgery. New York: Springer; 2015. p. 39–44.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Francisco Schlottmann
    • 1
    • 2
  • Marco Di Corpo
    • 2
  • Marco G. Patti
    • 3
    • 4
  1. 1.Department of SurgeryHospital Alemán of Buenos Aires, University of Buenos AiresBuenos AiresArgentina
  2. 2.Department of SurgeryUniversity of North CarolinaChapel HillUSA
  3. 3.Department of SurgeryCenter for Esophageal Diseases and Swallowing, University of NorthChapel HillUSA
  4. 4.Department of MedicineCenter for Esophageal Diseases and Swallowing, University of North CarolinaChapel HillUSA

Personalised recommendations