A Heller myotomy is used to treat achalasia surgically.  The idea is to cut the muscle around the lower esophageal sphincter near the gastroesophageal junction (where the esophagus and stomach meet) so that food is able to pass though.

Pre-Operative Details:

Your surgeon will give specific instructions before the surgery, including risks (i.e. bleeding, infection, esophageal leakage, acid reflux, etc.).  Please make sure to contact your insurance company for coverage.  You will also meet with the anesthesiologist prior to the surgery to go over your medical history.  On the day of surgery, you will arrive at the hospital, get registered, and get changed into a hospital gown.  A nurse will then review your chart to make sure there are no problems and then get all the paperwork in order for surgery.  The anesthesiologist will then start an IV and you will be taken to the operating room, where the surgeon will verify your name and procedure before any medication is given.  Once you are under anesthesia, surgery will begin.

Operative Details:

The surgery will either be done using laparoscopically (with several small incisions and using a camera to view the abdomen) or open surgery (one larger incision; if there specific factors requiring it).  The surgeon will locate the gastroesophageal junction and then make a longitudinal incision on the muscular ring of the lower esophageal sphincter to allow it to open and allow food to pass through.  Note: the surgeon may also perform additional procedures to prevent reflux, but this will be discussed prior to surgery.

Post-Operative Details:

After the surgery, you will be taken to the post-operative/recovery area or the intensive care unit and be monitored.  You will likely experience abdominal pain and will given pain medication appropriately.  It is important to keep the incision areas clean and dry.  The length of your hospital stay depends on how quickly you are able to eat and perform some physical activity.  If you experience difficulty in swallow, fevers, severe pain, redness/swelling/warmth where the incisions were made, or drainage from the incisions, please let your doctor know immediately.  Your surgeon will give specific instructions about recovery time.