A Heller myotomy is the standard treatment for people suffering from achalasia, a relatively rare esophageal disorder. Achalasia is a progressive disorder that weakens the gastroesophageal sphincter, the muscle connecting the esophagus to the stomach, making it increasingly difficult for the patient to swallow. A Heller myotomy permanently opens this sphincter, allowing food to pass easily into the stomach. Part of the stomach is then wrapped around the esophagus, a procedure called fundoplication, to prevent acid reflux or, a backflow of stomach acid.
When there is no contraindication, a Heller Myotomy is usually performed laparoscopically, involving only tiny incisions, less scarring and a speedier recovery than traditional surgery. During this minimally invasive procedure, miniature surgical instruments are inserted into small surgical openings and the doctor operates using ultrasound guidance. In most cases, a Heller myotomy is an outpatient procedure, but occasionally an overnight hospital stay is required.
A Heller myotomy is necessary because the symptoms of achalasia are not only uncomfortable, interfering with the quality of life, but may become life-threatening. When the gastroesophageal sphincter fails to relax and open, food becomes trapped in the esophagus, leading to heartburn, regurgitation, coughing and chest pain. Patients with achalasia may also become anemic. Left untreated, achalasia may eventually result in undesired weight loss, malnutrition or aspiration pneumonia. The cause of achalasia is unknown, but certain risk factors have been identified. These include:
- Hereditary factors
- Autoimmune disease
- Cancer of the esophagus
- Chagas disease, a parasitic infection
Heller myotomy is considered a safe and effective procedure for most patients with achalasia and is successful in a high percentage of cases. Like any surgery, however, a Heller myotomy involves certain risks. These risks may include:
- Excessive bleeding
- Blood clots
- Adverse reactions to anesthesia or medications
- Post-surgical infection
- Damage to adjacent organs
- Breathing problems
