Hellers Myotomy

Hellers myotomy is a surgical operation for achalasia. It is the most effective (90% relief of symptoms) and durable treatment for achalasia when compared to medication and endoscopic procedures. Hellers myotomy is performed laparoscopically, usually involving 5 keyhole incisions with the aim to split the muscle layer above, overlying and bellow the gastro-oesophageal sphincter. A partial stomach wrap is made to complete the operation in order to minimize reflux.

Post op recovery, follow up and diet

Patients usually experience immediate symptomatic relief. The routine hospital admission duration ranges from 1-3 days. You will be commenced on fluid diet prior to progressing to a puree diet for 2-3 weeks.

Patients who have undergone Hellers myotomy should still aim to sit upright during meals to ensure that food moves down with gravity. The nature of the disease means that the oesophagus will always have underlying issues with motility and function. The surgery is meant to promote oesophageal drainage through reducing the pressure point that is the distal oesophageal sphincter.

Patients who have had this procedure will also require long term follow up and surveillance gastroscopies in the rare instances of developing oesophageal tumours.

Heller’s myotomy risks and complications

Although uncommon, the operation (like other operations) carries a small risk of bleeding, infection, anaesthetic related issues and blood clots.

Myotomy specific complications that may occur:

• Delayed stomach emptying from vagus nerve injury
• Inability to burp, belch, bloating or increased flatus/ wind (due to wrap)
• Reflux
• Symptom recurrence