Heller myotomy is a form of surgery in which the muscles of the cardia (lower esophageal sphincter) are cut, allowing food/liquid to pass to the stomach. It was suggested by Heller in 1913 and was initially performed using an open procedure, thoracotomy, which carries significant risks and requires long recovery times. Modern Heller myotomy is performed using minimally invasive laparoscopic techniques, which minimize risks and speed recovery significantly.
During the procedure, the patient is put under general anesthesia. Five or six small incisions are made on the abdominal wall and a laparoscope is inserted into the area around the stomach. Assuming no complications, most healthy patients can take clear liquids later the same day and soft foods within 2-3 days. The typical hospital stay is 2-3 days and most patients can return to work after about a week. Heavy physical exertion is typically restricted for eight weeks or more.
This surgery (often combined with partial fundoplication to reduce the incidence of postoperative acid reflux) is used in the treatment of achalasia and is considered to be a long-term treatment--many patients do not require further treatment. Though it does not correct the underlying cause(s) and does not result in the complete absence of achalasia symptoms, the vast majority of patients find that the surgery greatly improves their ability to eat and drink.
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