February 20, 2021

Heller Myotomy with Dor Fundoplication to Treat Achalasia Video

In patients suffering from achalasia, the LES (lower esophageal sphincter) remains abnormally closed preventing food and liquids from easily passing into the stomach, especially given weak or even absent esophageal peristalsis. Food is essentially falling by gravity after swallowing. Given the delay in food passage into the stomach, the lower esophagus dilates. Symptoms stem from food failing to clear the LES leading to food regurgitation, difficulty swallowing, and even chest pain. Interestingly, achalasia symptoms are often confused with reflux.

Should conservative medical management fail to resolve symptoms, a Heller myotomy can be performed to widely open the LES by incising it in order to make it easier for food to fall into the stomach. Esophageal peristalsis is not able to be restored but resistance to food passage can at least be reduced surgically. Because the LES is wide open afterwards, the patient is at risk for significant reflux. The Dor fundoplication or partial anterior stomach wrap, is a gentle way to minimize risk of reflux after a Heller myotomy.

This animation was created with Dr. Kevin Gillian at the Virginia Heartburn and Hernia Institute

To watch actual surgical footage of these procedures, click here.

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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