Achalasia surgery

Achalasia (“non-ass flaccidity”) is a functional disorder of the oesophagus, which manifests itself through difficulty swallowing, choking, burping and/or chest pain and is very restrictive for those affected in their daily lives. If conservative treatment approaches are not able to improve the achalasia sufficiently, surgery can be resorted to. In this procedure, the muscles of the lower esophagus are cut open lengthwise from the outside while protecting the mucous membrane, which means that a too narrow area can be widened.

The classic surgical procedure for achalasia is the so-called extramucosal myotomy according to Heller. Here the surgeon reaches the oesophagus through a large abdominal incision (transabdominal). Since the introduction of gastroscopy (flexible endoscopy), however, it has increasingly become a standard procedure, as this operation is only minimally invasive.

This means that the operation is performed laparoscopically, which is much gentler on the patient. This procedure does not require a large skin incision, only 5 small incisions are needed to gain access to the lower esophagus or upper stomach. With the help of a small camera, which is inserted during this procedure, the myotomy is then observed.

The incisions are then closed again (skin suture), covered with a sterile plaster and the patient can be transferred to the recovery room. The average length of hospital stay for this operation is about 10 days. During this period, a gradual build-up of food takes place, initially the patient is fed parenterally (past the intestine) via infusions.

Then small amounts are administered until normal food is gradually allowed to return, so as not to overstrain the treated area too quickly. Later, depending on individual needs, a follow-up treatment (rehabilitation) can be requested, which can last up to three weeks. Normally, a patient is then able to resume his or her everyday life and work without restrictions.

Nevertheless, even if he is free of symptoms, he should see his doctor about every six months to remain under supervision. The operation for achalasia is not associated with a high risk because it is only minimally invasive. However, complications can always arise during an operation, such as A further complication of this special procedure is the piercing of the mucous membrane, but this can usually still be discovered and remedied intraoperatively.

In any case, the surgeon will inform you in detail about the complications before the upcoming operation. With a success rate of 80 to 90%, this therapy option is considered very effective. Although it does not treat the cause of the disease, but only alleviates its symptoms, only about 5% of the treated patients experience recurrent symptoms later. – Wound infections