Heller Myotomy


What is a Heller Myotomy?
The heller myotomy is a procedure used to treat a condition called achalasia. Achalasia is a condition where patients have difficulty swallowing because the muscle fibers at the junction of the esophagus and stomach fail to relax to allow food passage. Food then becomes stuck. Regurgitation of undigested food is a common complaint as well as a history of hospital admissions for pneumonia. The heller myotomy is a procedure that cuts the circular sphincter muscles at the junction of the esophagus and stomach.

How is a Laparoscopic Heller Myotomy performed?
Laparoscopic surgery uses a thin, telescope-like instrument called a laparoscope which is inserted through a small incision in the umbilicus. The laparoscope is connected to a tiny video camera which projects a video image of the operative site onto video monitors in the operating room. The abdomen is inflated with carbon dioxide, a gas, to allow your surgeon a better view of the operative area. A total of six incisions will be made with an umbilical incision, two incisions on each side of the upper abdomen and one just below the breast bone. Instruments are inserted through these incisions. The esophagus is dissected away from the diaphragm muscles. A lighted tube is then placed in the esophagus to help with dissection of the muscular layers. The outer longitudinal muscular layer of the esophagus is separated extending from the lower third of the esophagus onto the stomach. The inner circular muscle layer of the esophagus is then exposed and divided. Cutting the circular muscle disables the lower esophagus sphincter thus allowing food passage.

Please note that Dr. Rosser usually performs the heller myotomy in conjunction with the toupet fundoplication procedure. Please click here for more information on this procedure.

Why Laparoscopic?

  • ___Six tiny scars instead of one large abdominal scar.
  • ___Shorter hospital stay.
  • __ Reduced post-operative pain.
  • ___Shorter recovery time and quicker return to daily activities, including work.
  • What can I expect after surgery?
    It is important to follow Dr. Rosserís instructions after surgery. You will be started on a liquid diet the day after surgery. If liquids are tolerated, you will be discharged the second day after surgery. You will be on liquids for two weeks followed by a pureed diet eventually progressing to regular food after approximately a monthís time.

    To make an appointment with Dr. Rosser, please call 212-420-4337.