Achalasia is a rare disorder, caused by a nerve malfunction in the esophagus and sphincter, the valve controlling food passage from the esophagus to the stomach.  Normally, the sphincter relaxes during swallowing.  Achalasia causes the muscle ring to not relax as well.

This disease makes it difficult for food and liquid to pass into the stomach, causing symptoms that develop gradually over time.

Symptoms include:

• Regurgitation of food
• Chest pain that may increase after eating or may be felt in the back, neck and arms
• Cough
• Difficulty swallowing liquids and solids
• Heartburn
• Unintentional weight loss

Achalasia often results in anemia or malnutrition, as sufferers have difficulty consuming foods.  The most common treatment approaches involve methods to reduce pressure on the sphincter.  Some patients may receive injections of botulinum toxin, to relax the sphincter muscles for up to a few months.  Medications, including long-acting nitrates or calcium channel blockers, also serve the same function, although if successful induces longer-term benefits. If these methods fail to offer a long-term solution to the symptoms, a doctor may suggest a surgical solution known as Heller Myotomy.

Heller Myotomy

Heller Myotomy is the primary surgical solution for complications arising from Achalasia.  The procedure is named after its first performer, Ernest Heller, and originally involved a single incision of 6-10 or more in the upper abdomen.

Now, Heller Myotomy is almost always performed laparoscopically, with three to four tiny incisions, through which tools and a camera are inserted.  The patient will undergo general anesthesia before the procedure begins.  The abdomen is filled with gas to expand the cavity, creating more room for the surgeon to work.  If other conditions make open surgery necessary, a single, large incision will be made to expose the affected area.

Once inside, the sphincter is located and a lengthwise incision is made on the muscular ring surrounding it.  This effectively weakens the muscle, enabling the lower esophageal sphincter to open more easily.  Results from surgery vary.  Those who have recently undergone Heller Myotomy should watch out for fever, difficulty swallowing, worsening pain, or redness, warmth, swelling around or drainage from the incision.  These could be indicators of infection or serious complications.

If your doctor has recommended surgery to treat your achalasia, inquire about the minimally invasive robotic Heller Myotomy at The Jackson Clinic.  With the most advanced surgical technologies and state-of-the-art techniques, The Jackson Clinic offers all the benefits of traditional surgery with minimized incisions.