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Achalasia — Heller Myotomy

Surgical division of the lower oesophageal sphincter for achalasia, with partial fundoplication.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Achalasia — Heller Myotomy?

Achalasia is a primary oesophageal motility disorder characterised by failure of lower oesophageal sphincter relaxation and absent peristalsis.

Heller myotomy involves longitudinal division of the muscle layers of the distal oesophagus and proximal stomach for six to eight centimetres total length.

Performed laparoscopically with an anti-reflux partial fundoplication (anterior Dor or posterior Toupet), it provides durable symptom relief in over 90% of patients.

Symptoms

Progressive dysphagia for solids and liquids
Regurgitation of undigested food
Retrosternal chest pain
Weight loss and malnutrition
Aspiration pneumonia in advanced disease
Heartburn unresponsive to proton pump inhibitor

Risk Factors

Age 30 to 60 years (peak)
Family history of achalasia (rare genetic forms)
Chagas disease (in endemic regions)
Other autoimmune disorders

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent dysphagia and weight loss
  • Recurrent chest pain and aspiration episodes
  • Symptoms refractory to medical management or pneumatic dilatation
  • Confirmed manometric diagnosis (type I, II, III achalasia)

Treatment Methods

01
High-resolution oesophageal manometry confirms diagnosis and subtype
02
Barium swallow showing bird-beak appearance and dilatation
03
Endoscopy excludes pseudoachalasia and malignancy
04
Laparoscopic Heller myotomy with Dor or Toupet fundoplication (gold standard)
05
Per-oral endoscopic myotomy (POEM) — emerging endoscopic alternative
06
Pneumatic dilatation or botulinum toxin for poor surgical candidates

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.