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Heller myotomy is a surgical procedure [1] in which the muscles of the cardia (lower esophageal sphincter or LES) are cut, allowing food and liquids to pass to the stomach.It is used to treat achalasia, a disorder in which the lower esophageal sphincter fails to relax properly, making it difficult for food and liquids to reach the stomach.
Transoral incisionless fundoplication (TIF) is an endoscope treatment designed to relieve symptoms of gastroesophageal reflux disease (GERD). The TIF procedure, similar to Nissen fundoplication , alleviates GERD symptoms by wrapping a portion of the stomach around the esophagus.
After surgery, patients should keep to a soft diet for several weeks to a month, avoiding foods that can aggravate reflux. [33] The most recommended fundoplication to complement Heller myotomy is Dor fundoplication, which consists of a 180- to 200-degree anterior wrap around the esophagus. It provides excellent results as compared to Nissen's ...
Nissen (complete) fundoplication is generally considered to be safe and effective, with a mortality rate of less than 1% and many of the most common post-operative complications minimized or eliminated by the partial fundoplication procedures now more commonly used. Studies have shown that after 10 years, 89.5% of patients are still symptom-free.
Average mortality rates (deaths either in hospital or within 30 days of surgery) for the operation are around 10% in US hospitals. Recognized major cancer hospitals typically report mortality rates under 5%. Major complications occur in 10–20% of patients, and some sort of complication (major and minor) occurs in 40%.
Named after the Major League Baseball pitcher who was the first professional athlete to undergo the procedure, in 1974. [8] Toupet fundoplication: Andre Toupet: Upper gastrointestinal surgery: Fundoplication with 270° posterior wrap: Laparoscopy Hospital article: Trendelenburg's operation [9] Friedrich Trendelenburg: Cardiothoracic surgery
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The device for carrying out the procedure was originally developed by a company called Curon which obtained FDA approval for the device in 2000 but then went bankrupt in 2006; the device was brought back to market by Mederi Therapeutics in 2010. [2] [6] The procedure costs between $3,000 and $4,000 as of 2004. [7]