Heller myotomy

Anatomy

The entry into the stomach is called the cardia. This is where the lower oesophageal sphincter sits.

 

Indications

• Oesophageal achalasia: failure of the lower oesophageal sphincter to relax and allow passage of oesophageal contents into the stomach.

 

Procedure

The muscles of the cardia are cut (myotomy). This allows easier entry into the stomach.
The loss of cardia function can result in post-operative GORD.
Often an anterior (Dor) fundoplication is performed, to reduce reflux.
Complete (Nissen) fundoplication should not be performed due to the absent peristalsis in achalsia.