Heller Myotomy (Achalasia Surgery) (100-150)
A Heller Myotomy is a surgical procedure designed to treat achalasia. Achalasia is disease in which the muscular valve between the lower esophagus and stomach fails to properly relax and open, creating a problem with swallowing food. During a Heller Myotomy, the muscle around the lower esophagus is cut. This procedure is performed under general anesthesia (the patient is asleep) using one large incision (“open surgery”) or several smaller incisions (laparoscopic surgery). First, the abdomen is filled with gas in order to inflate the area for better visualization and access to the affected area. During laparoscopic Heller Myotomy procedures, 3 or 4 small incisions are made in the abdomen. Through these incisions, the surgeon inserts a tube with a camera on the end (laparoscope) and small surgical instruments. A lengthwise incision is then made in the muscle around the lower esophagus, allowing it to open more easily. Sometimes, surgeons perform an additional procedure after a Heller Myotomy to prevent acid reflux (i.e., stomach acid flowing up the esophagus). This procedure, called a low-resistance fundoplication, involves wrapping the upper portion of the stomach around the esophagus.