✦ ACHALASIA CARDIA · LAPAROSCOPIC · GOLD STANDARD

Laparoscopic Heller Myotomy

Q: How quickly does swallowing improve after laparoscopic myotomy?

Most patients notice immediate improvement from day one. Liquids on day one, soft foods by week two, and a full diet within 4–6 weeks.

Q: Is laparoscopic myotomy better than pneumatic dilation?

Laparoscopic Heller Myotomy provides more durable relief — 90%+ success at 10 years versus 50–60% with dilation, which often requires repeat procedures.

Q: What is the risk of reflux after myotomy?

Dividing the LES creates reflux risk, which is why a partial fundoplication (Dor or Toupet wrap) is always added.

Keyhole division of the lower oesophageal sphincter with partial fundoplication — gold standard for achalasia cardia.

60–120 Min TREATMENT DURATION

2–3 Days CARE SETTING

Laparoscopic APPROACH

2–3 Weeks RECOVERY TIMELINE

What is Laparoscopic Heller Myotomy?

Laparoscopic Heller Myotomy is the gold standard minimally invasive treatment for achalasia cardia. Through 5 small keyhole incisions, the lower oesophageal sphincter muscle is precisely divided, permanently relieving the obstruction preventing normal swallowing. Dr. Tagore Mohan Grandhi performs laparoscopic Heller Myotomy. A partial fundoplication prevents post-operative reflux. Over 90% of patients achieve excellent, durable swallowing function with a 2–3 day hospital stay.

Suitable for patients with confirmed achalasia on high-resolution manometry (bird-beak sign), in whom surgery is preferred over dilation or Botox for durable long-term relief.

How the Procedure Works

Diagnostic Confirmation

Manometry, barium swallow, and upper GI endoscopy performed to confirm diagnosis and exclude malignancy before surgery.

Laparoscopic Access

Five keyhole incisions (5–12 mm). Gastro-oesophageal junction visualised under laparoscopic magnification.

Myotomy

LES muscle fibres divided precisely — 6 cm onto the oesophagus and 2 cm onto the stomach. Completeness of myotomy confirmed by mucosal bulge.

Partial Fundoplication

Dor (anterior) or Toupet (posterior) wrap added based on manometry findings to prevent post-myotomy GERD.

Recovery

Liquids day one, soft foods week two. Immediate swallowing improvement noted. Return to normal diet by 2–4 weeks.

Outcomes

60–120 MinTREATMENT DURATION

2–3 DaysCARE SETTING

LaparoscopicAPPROACH

2–3 WeeksRECOVERY TIMELINE

Who Needs This Treatment?

→5 keyhole incisions — significantly less pain than open myotomy
→90%+ long-term success — most durable treatment for achalasia
→2–3 day hospital stay versus 3–5 days for open approach
→Partial fundoplication prevents post-myotomy acid reflux

Laparoscopic Heller Myotomy is one of the most satisfying operations we perform. Patients swallow normally within days after years of struggling. Results are consistently excellent and long-lasting.

— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

How quickly does swallowing improve after laparoscopic myotomy?+

Is laparoscopic myotomy better than pneumatic dilation?+

What is the risk of reflux after myotomy?+

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