Thoracoscopic Heller's myotomy. Treatment of achalasia by the videoendoscopic approach.

In summary, the authors believe that minimally invasive surgery has added a new dimension to the treatment of achalasia. Thoracoscopic myotomy is feasible, safe, and effective in relieving dysphagia in the great majority of individuals affected with this disease without the many problems associated with dilatation; thus, the authors offer it to patients with achalasia as the initial and preferred form of treatment. Whether an antireflux procedure should be routinely added and whether a laparoscopic rather than a thoracoscopic approach is preferred, remains unanswered questions at this time.