Heller myotomy is a surgical technique used to treat the symptoms of achalasia , a disorder that affects an individual’s ability to pass foods and liquids into the stomach. Heller myotomy is considered a minimally invasive procedure because it uses several small incisions instead of one larger incision.

Why Heller Myotomy Is Performed

Achalasia is a serious condition that develops when nerve cells of the esophagus are damaged or lose function. When this occurs, certain muscles of the esophagus, called the lower esophagus sphincter, are unable to fully relax and let food pass through to the stomach.

Common symptoms experienced with achalasia include:

  • Indigestion (a burning sensation in the chest area)
  • Dysphagia (difficulty swallowing or feeling as if there is food stuck in the throat or in the chest)
  • Regurgitation (food or liquid that flows back up into the throat)

Heller myotomy surgery aims to release these muscles in order to allow food and liquids to be easily and comfortably transferred from the mouth, through the esophagus, and to the stomach.

What to Expect During a Heller Myotomy Procedure

During a Heller myotomy procedure, patients are placed under general anesthesia. A small incision is made just above the navel (belly button). Through this incision, the surgeon inserts a thin tube that fills the abdominal area with a harmless carbon dioxide gas in order to be able to see the organs better. Then an instrument called a laparoscope is inserted into the incision and through to the abdomen. A laparoscope is a thin flexible tube with a light and camera attached to the end that allows surgeons to view, on a monitor, the inside of the abdomen. Next, additional incisions are made in the abdomen where the surgeon will insert thin flexible tubes with instruments attached to the end, which are used to perform the surgery.

A portion of the muscle surrounding the lower part of the esophagus, closest to the stomach, is carefully cut and removed. This maintains the esophagus open, allowing food and liquid to easily pass into the stomach.

Risks Associated with Heller Myotomy

Heller myotomy is a minimally invasive surgery, which means that overall, it has fewer risks for patients compared to an open procedure. However, every surgery comes with at least minor risks. Risks associated with Heller myotomy surgery include:

  • Damage to the internal organs
  • Postoperative infection
  • Bleeding

Additionally, some patients who have Heller myotomy surgery may develop gastroesophageal reflux disease (GERD) later in life.

Benefits of Heller Myotomy

Since there is no cure for achalasia, Heller myotomy surgery aims to relieve the symptoms of the condition. Additionally, the nature of Heller myotomy as a minimally invasive surgery offers various benefits to patients, such as:

  • Smaller incisions
  • Less postoperative time in the hospital
  • Less postoperative pain
  • Faster recovery times and quicker return to daily activities

How to Prepare for Heller Myotomy

Prior to surgery, the surgeon will give specific instructions to follow during a pre-operative appointment. These instructions will most likely include the following:

  • Do not eat or drink anything after midnight the night before the procedure
  • Do not take any medications that thin the blood, such as aspirin or ibuprofen, one week prior to surgery

Post Heller Myotomy Treatment

Patients will most likely stay in the hospital overnight immediately following Heller myotomy surgery. Typically, if there are no immediate complications, patients are allowed to return home within one to two days after the procedure.

Caregivers will evaluate whether a patient is eligible to be released by performing what’s called a swallowing study. A swallowing study is a test used to evaluate the integrity of the esophagus following Heller myotomy surgery. If the results of this test are normal, patients are educated on how to follow a liquid diet and sent home. Follow up appointments will be necessary to monitor healing of the operated area and to educate the patient on how to transition from a liquid diet, to a diet consisting of soft foods, and eventually, to a normal diet.

Patients will be asked to avoid lifting for two to four weeks to allow the incisions in the abdomen to heal. Patients who do not experience any serious health complications can typically return to work within one to two weeks following the operation.

Make an Appointment

For an appointment with a specialist, call 202-877-3627.