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. Rosser’s 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 month’s time.
To make
an appointment with Dr. Rosser, please call 212-420-4337.
