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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.
The shortcoming of laparoscopic esophageal myotomy is the need for a fundoplication. On the one hand, the myotomy opens the esophagus, while on the other hand, the fundoplication causes an obstruction. Recent understanding of the gastroesophageal antireflux barrier/valve has shed light on the reason for the occurrence of reflux following myotomy.
Diagram of esophageal motility study in nutcracker esophagus: The disorder shows peristalsis with high-pressure esophageal contractions exceeding 180 mmHg and contractile waves with a long duration exceeding 6 sec. Normal esophagus in (A). Nutcracker esophagus in (C): high-pressure waves in blue; cross-sectional areas (CSA) in fucsia.
Heller myotomy – Muscles of the cardia (lower oesophageal sphincter or LOS) are cut, allowing food and liquids to pass to the stomach; Hymenotomy – Surgical removal or opening of the hymen; Hysterotomy – Incision in the uterus, and is performed during a Caesarean section; Laminotomy – The partial removal (or by making a larger opening ...
Myotomy is a surgical procedure that involves cutting a muscle to relieve constriction, often performed in the gastrointestinal or urological systems. The procedure can alleviate symptoms caused by muscle-related functional obstructions, particularly in cases of achalasia, a disorder that affects the esophagus.
The per-oral endoscopic myotomy, or POEM, is a minimally invasive surgical procedure for the treatment of achalasia wherein the inner circular muscle layer of the lower esophageal sphincter is divided through a submucosal tunnel. [1] This enables food and liquids to pass into the stomach, a process that is impaired in achalasia.
Diagram showing before and after an oesophago-gastrectomy. There are two main types of esophagectomy. A transhiatal esophagectomy (THE) is performed on the neck and abdomen simultaneously. [2] A transthoracic esophagectomy (TTE) involves opening the thorax (chest).
Diagram of esophageal motility study in 'nutcracker esophagus'. The disorder shows peristalsis with high pressure esophageal contractions exceeding 180 mmHg and contractile waves with a long duration exceeding 6 seconds.