Laparoscopic Heller Procedure (Cardiomyotomy)
This is an operation for achalasia of the cardia, a condition in which the muscle in the lower oesophagus fails to relax and therefore hinders the passage of food and fluid into the stomach. Treatment with Botox injections or balloon dilatation of the affected part of the oesophagus can be attempted but are often short-lived and surgery is frequently required as a more lasting solution.
Under general anaesthesia, 5 small keyhole incisions are made on the abdomen and laparoscopic instruments are introduced. The lower oesophagus is approached and a lengthwise cut is made in the muscle layer of the lower oesophagus. Care is taken to cut only the muscle layer, leaving the inner lining of the oesophagus intact. As this procedure is often complicated by acid reflux after the operation, a partial or complete fundoplication is also performed at the same time to minimise this.
Intake of food should become more comfortable soon after surgery and a near-normal diet can be maintained.