Laparoscopic stapled cardioplasty for end-stage achalasia

J Gastrointest Surg. 2013 May;17(5):997-1001. doi: 10.1007/s11605-012-2111-3. Epub 2012 Dec 12.

Abstract

Introduction: The standard of care for achalasia is laparoscopic Heller's cardiomyotomy. This procedure achieves satisfactory and long-standing results in over 85 % of patients. However, in 10-15 % of patients, esophageal function will progressively deteriorate, and up to 5 % will develop end-stage achalasia. Options in these difficult patients are limited, and include redo cardiomyotomy, repeat dilatation, and in severe cases, esophagectomy.

Methods: In this report, we describe an alternate approach, a cardioplasty, which was originally described by Heyrovsky in 1913.

Results: The development of an angulated stapling device now makes this operation feasible by a laparoscopic approach.

Conclusion: This report highlights our technique for laparoscopic cardioplasty in patients with end-stage achalasia.

MeSH terms

  • Adult
  • Cardia / surgery*
  • Esophageal Achalasia / surgery*
  • Female
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Surgical Stapling / instrumentation*
  • Treatment Outcome