Laparoscopic Heller cardiomyotomy with intraoperative manometry in the management of oesophageal achalasia.

Results of an ongoing clinical study treating achalasia patients with laparoscopic Heller myotomy and Dor anterior fundoplication are presented. 18 patients underwent surgery between August 1991 and July 1995. Completeness of myotomies and calibration of fundoplications were measured using intraoperative manometry. Only one intraoperative complication, a perforation of the mucosa sutured laparoscopically, was encountered. There were no surgical mortalities nor postoperative morbidities. Mean hospital stay was 3.4 days. Complete relief of dysphagia and modifications of radiological and manometric patterns were achieved in all patients. All patients remain asymptomatic at 2 to 48 months from surgery. These results compare favourably with those of traditional surgery and of pneumatic dilatation.