Laparoscopic surgery for achalasia cardia

Laparoscopic surgery for achalasia cardia is a minimally invasive procedure aimed at relieving symptoms caused by this esophageal motility disorder, where the lower esophageal sphincter (LES) fails to relax, leading to difficulty in swallowing, regurgitation, and chest pain.

Most Common Procedure: Laparoscopic Heller Myotomy (LHM)

What It Involves:

• The surgeon cuts the muscle fibers of the lower esophageal sphincter (LES) to allow food to pass into the stomach more easily.
• Typically performed via 5 small incisions in the abdomen using a laparoscope (a camera-guided instrument).
• Often combined with a partial fundoplication (e.g., Dor or Toupet) to prevent postoperative acid reflux.

Indications for Laparoscopic Surgery

• Failed response to less invasive treatments like:
  • Pneumatic dilation
  • Botulinum toxin injection
  • Medications (e.g., nitrates, calcium channel blockers)
• Young and fit patients seeking a long-term solution
• Preference for a definitive treatment over repeated dilations

Benefits of Laparoscopic Heller Myotomy

• Minimally invasive: shorter hospital stay, less pain, quicker recovery
• Durable symptom relief (>90% success rate)
• Lower risk of complications compared to open surgery
• Can be done robotically (Robotic Heller Myotomy) for added precision