Laparoscopic Heller Myotomy and Dor Fundoplication

Abstract

Esophageal achalasia is a primary esophageal motility disorder characterized by lack of peristalsis and by incomplete or absent relaxation of the lower esophageal sphincter in response to swallowing. The cause of the disease is unknown.

The goal of treatment is to eliminate the functional outflow obstruction at the level of the gastroesophageal junction, therefore allowing emptying of the esophagus into the stomach. Available treatment modalities include laparoscopic Heller myotomy with partial fundoplication, pneumatic dilatation, and per-oral endoscopic myotomy. Esophagectomy is considered a last resort for patients who have failed prior therapeutic attempts.

In this evidence and experience-based chapter we will illustrate the technique of the laparoscopic Heller myotomy with partial anterior fundoplication (Dor) for esophageal achalasia.