Heller myotomy is a surgical procedure in which the muscles of the lower esophageal sphincter (LES) are cut to treat achalasia, a condition where the muscles of the esophagus fail to relax, causing difficulty in swallowing, chest pain, and regurgitation of food. Achalasia occurs due to nerve damage in the esophagus, leading to a lack of coordinated muscle contractions and failure of the LES to open properly, obstructing food from entering the stomach. Heller myotomy helps by relieving the muscle tightness, allowing food and liquids to pass more easily into the stomach.
This procedure is typically performed using minimally invasive techniques, such as laparoscopy or robotic-assisted surgery. It is often combined with a partial fundoplication, where the upper part of the stomach is wrapped around the esophagus to reduce the risk of post-operative acid reflux. Though Heller myotomy is highly effective in improving swallowing and quality of life, there are potential complications. These may include gastroesophageal reflux disease (GERD), as cutting the muscle can weaken the LES, leading to stomach acid flowing back into the esophagus. Other risks include infection, bleeding, or injury to surrounding organs during surgery. In some cases, the procedure may not completely relieve symptoms, and further treatment may be necessary. Despite these risks, Heller myotomy is considered the best treatment for achalasia, offering long-term relief of symptoms and allowing most patients to resume a normal diet and lifestyle. Proper post-operative care and monitoring are essential to manage any complications.
