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Advanced Heller Myotomy Surgery

Heller myotomy offers a surgical solution that works for patients who struggle with achalasia, a degenerative disease affecting their oesophagus's normal function. The procedure requires surgeons to cut through the lower oesophageal sphincter's muscles so food and liquids can easily reach the stomach.

Laparoscopic Heller myotomy has evolved into the standard treatment for achalasia. Surgeons create five or six small incisions in the patient's abdominal wall and insert specialised instruments through them. This technique allows the surgeons to extend well beyond the gastroesophageal junction. 

This article covers everything about Heller myotomy for achalasia. You will learn about preparation, surgical steps, recovery, and what it all means for patients.

Why CARE Group Hospitals is Your Top Choice for Heller Myotomy Surgery in Hyderabad

CARE Hospitals delivers exceptional Heller myotomy treatment because of:

  • A core team of thoracic surgeons, gastroenterologists and specialised staff working together
  • Years of success treating complex oesophageal disorders
  • Treatment plans tailored to each patient's needs
  • Detailed support before and after surgery

Best Heller Myotomy Surgery Doctors in India

  • C P Kothari
  • Karunakar Reddy
  • Amit Ganguly
  • Biswabasu Das
  • Hitesh Kumar Dubey
  • Biswabasu Das
  • Bhupathi Rajendra Prasad

Innovative Surgical Advances at CARE Hospital

CARE Hospital uses state-of-the-art methods for Heller myotomy procedures. The laparoscopic approach reduces post-surgery pain by a lot, and patients stay only 1-2 days in the hospital instead of a week with traditional surgery. The hospital also uses robotic Heller myotomy with the da Vinci Xi system that gives surgeons superior 3D views of oesophageal wall layers.

Indications for Heller Myotomy Surgery

We recommend Heller myotomy mainly for achalasia, where the lower oesophageal sphincter doesn't relax properly. Patients with unsuccessful previous treatments, a sigmoid-shaped oesophagus, or specific spastic oesophageal disorders might also benefit from this procedure.

Types of Heller Myotomy Procedures

CARE Hospital performs these Heller myotomies in the following approaches:

  • Laparoscopic Heller myotomy—minimal invasion using small cuts in the abdomen
  • Robotic Heller myotomy—precise control through robotic technology
  • Heller myotomy with fundoplication—has Dor fundoplication to stop reflux after surgery

Pre-Heller Myotomy Surgery Preparation

Patients need to follow these steps before surgery:

  • Clear liquid diet 48 hours before the procedure
  • Nothing to eat or drink after midnight on surgery day
  • Stop blood thinners and NSAIDs 1-2 weeks before the procedure as instructed
  • Stop smoking at least 4 weeks before surgery
  • Wear compression stockings to prevent deep vein thrombosis
  • A complete pre-anaesthetic evaluation and diagnostic tests should be done

Heller Myotomy Surgical Procedure

The laparoscopic Heller myotomy happens under general anaesthesia and includes:

  • Creation of five small abdominal incisions
  • Abdomen inflation with carbon dioxide for better visibility
  • Careful cutting of oesophageal muscle layers while keeping the inner lining intact
  • Myotomy extension 6-8 cm up the oesophagus and 2-3 cm onto the stomach
  • Addition of Dor or Toupet fundoplication to prevent reflux
  • This entire process might takes of 2-4 hours

Post-surgery Recovery

Recovery involves these steps:

  • 1-2 day hospital stay for laparoscopic surgery
  • A barium swallow test on day one checks for leaks
  • The diet starts with clear liquids and progresses to soft foods
  • Normal activities resume within 2-3 weeks
  • Heavy lifting restrictions remain indefinitely
  • The oesophagus heals completely in 6-8 months

Risks and Complications

Patients should know these possible potential risks:

  • Oesophageal perforation 
  • Gastroesophageal reflux disease might develop
  • Barrett's oesophagus might occur
  • Esophagitis is possible in some rare cases
  • Some rare cases need reoperation due to recurring dysphagia

Benefits of Heller Myotomy Surgery

This procedure provides significant advantages:

  • Symptoms improve in the majority of patients 
  • The laparoscopic approach causes less pain than open surgery
  • Hospital stays are shorter—1-2 days versus 1 week for open surgery
  • Patients return to work and daily activities faster
  • Results last long-term

Insurance Assistance for Heller Myotomy Surgery

CARE Hospitals helps patients with insurance by:

  • Explaining coverage limits clearly
  • Working directly with third-party administrators
  • Providing clear information about healthcare costs

Second Opinion for Heller Myotomy Surgery

Additional medical opinions help patients to:

  • See different treatment options
  • Verify their original diagnosis and recommended treatment
  • Learn about non-surgical options when possible
  • Understand the procedure's risks and likely outcomes

Conclusion

Heller myotomy has proven to be an effective treatment for patients with achalasia. Since its introduction in 1913, the procedure has evolved substantially. Today's laparoscopic and robotic approaches help patients recover faster with less pain compared to traditional open surgery. 

CARE Hospital's team in Hyderabad provides detailed care throughout your treatment. Their specialists combine surgical expertise with advanced technology to create customised treatment plans. The hospital's integrated team approach supports patients at every stage—before, during, and after surgery.

Heller myotomy has ended up changing lives for many people with achalasia. The procedure's long history and improvements through minimally invasive techniques show its importance as a treatment that helps thousands of patients overcome this challenging condition.

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Heller Myotomy Surgery Hospitals in India

Frequently Asked Questions

Heller myotomy is a surgical procedure that helps food and liquids pass more easily into the stomach by cutting the muscles of the lower oesophageal sphincter (LES). This surgery fixes achalasia, a condition that makes it hard to swallow because a tight LES stops food from moving down the oesophagus properly.

Doctors recommend Heller myotomy in these situations:

  • Regular medications don't help with symptoms
  • Patients start losing weight and have trouble swallowing
  • The risk of aspiration becomes high
  • Other treatments like endoscopic dilation or botulinum toxin injections haven't worked

The best candidates are:

  • Younger patients (under 40) who would need lifelong dilations otherwise
  • People whose symptoms persist after trying multiple non-surgical treatments
  • Patients who want surgery as their first treatment option
  • Anyone healthy enough to handle general anaesthesia

Yes, it is. Medical experts call it very safe. In spite of that, like any surgery, patients should think about what it all means.

Patients usually feel some soreness at their incision sites and discomfort in their throat and chest after surgery. Pain management medications work well to control these symptoms.

The surgery usually takes 1-3 hours. Some medical sources say it might take up to 4 hours.

Yes, doctors classify Heller myotomy as major surgery, especially with the open surgical approach. The laparoscopic method offers shorter recovery times and hospital stays.

Possible complications include:

  • Oesophageal perforation 
  • Gastroesophageal reflux disease (GERD)
  • Barrett's oesophagus
  • Esophageal infection
  • Ongoing difficulty swallowing

Patients usually head home within 1-2 days. They need 7-14 days to recover at home and can resume normal activities after 3 weeks. Patients who undergo open surgery might need to take a month off work.

The surgery helps the majority of patients feel better. Results show that many patients still see benefits after 10 years. All the same, some patients might develop GERD symptoms 3-5 years after their surgery. This procedure helps manage symptoms but isn't a cure—symptoms can return over time in some rare cases.

Doctors use general anaesthesia with endotracheal intubation. Patients stay completely asleep throughout the procedure. The surgical team places small tubes in the patient's stomach, bladder, and windpipe during the operation. Today's anaesthetic methods are very safe.

The surgery isn't suitable for patients with high surgical risks or those who don't want the procedure. Previous pneumatic dilation doesn't rule out this surgery.

You should avoid:

  • Heavy lifting for 6 weeks
  • Foods causing gas
  • Drinking through straws and chewing gum
  • Spicy or acidic foods at first

The diet starts with clear liquids, moves to soft foods in 2-3 days, and returns to normal within 4-8 weeks. Eating slowly and chewing food well helps patients adjust. Some foods might still be challenging to eat at first.

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