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What is achalasia surgery?

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Achalasia surgery is a medical procedure performed to weaken the muscular pressure exerted on the lower esophageal sphincter, or LES, to provide symptomatic relief to patients. A surgical technique, known as the Heller myotomy, provides long-term symptom relief for achalasia patients, states the Department of Surgery at the Washington University School of Medicine in St. Louis.

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Achalasia is a rare esophageal disorder characterized by the inability to transport food from the mouth to the stomach. This condition occurs when there is damage to the nerve fibers lining the esophagus that results in the impairment of the LES, which is the muscular ring that normally opens during swallowing. Following diagnosis, a physician may recommend surgery as the best treatment plan for a patient.

Open achalasia surgery involves forming a large incision on the patient's midsection to access, cut and relieve pressure on the LES. On average, this type of procedure entails around a week of hospitalization and a prolonged healing process, notes da Vinci Surgery.

A minimally invasive Heller myotomy utilizes the laparoscopic method by which only a tiny incision is made on the area right above the navel. An empty tube-like device called a trocar is then inserted, and the stomach is infused with gaseous carbon dioxide. A scope equipped with a light and camera is also inserted into the tube to capture and transmit images of the abdominal organs.

Based on the visualization obtained, surgeons determine four other areas of the abdomen where additional trocars are placeable. Small incisions are then made on these locations. After lodging the trocars, surgical instruments are inserted into the tubes and the surgeons carry out the surgery to cut the LES. Patients generally require only a day or two of hospitalization with this type of achalasia surgery.

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