BACKGROUND Undetected perforation during laparoscopic pyloromyotomy can be fatal. Detecting a perforation at the time of laparoscopic pyloromyotomy is difficult. The purpose of this study was to determine whether air insufflation of the stomach reliably detects perforation during laparoscopic pyloromyotomy. CASE REPORTS Between 2007 and 2008, 71 patients underwent laparoscopic pyloromyotomy a...

Achalasia is an esophageal motility disorder of unknown cause, characterised by aperistalsis of the esophageal body and impaired lower esophageal sphincter relaxation. Patients present at all ages, primarily with dysphagia for solids/liquids and bland regurgitation. The diagnosis is suggested by barium esophagram or endoscopy and confirmed by esophageal manometry. Achalasia cannot be cured. Ins...

Esophageal achalasia is a primary motility disorder characterized by impaired lower esophageal sphincter relaxation and absence of esophageal peristalsis leading to impaired bolus transit, manifested with symptoms such as dysphagia, regurgitation, retrosternal pain, and weight loss. The standard diagnostic tool is esophageal manometry which demonstrates incomplete relaxation of the lower esopha...

Laparoscopic Heller’s myotomy is the most common surgical procedure to treat achalasia. It is the most accepted therapy for non-advanced stages of the disease. In the setting of advanced disease with marked esophageal dilatation or sigmoid-shaped esophagus the ideal surgical procedure is debatable. Esophagectomy is believed by several authors to be the operation of choice in these cases. Others...

BACKGROUND Laparoscopic pyloromyotomy is associated with an increased risk of incomplete myotomy compared with open myotomy. We hypothesized that utilizing ultrasound measured length to direct laparoscopic pyloromyotomy would reduce the risk of incomplete pyloromyotomy without a concomitant increase in the risk of mucosal perforation. METHODS Infants (n=43) with hypertrophic pyloric stenosis ...

BACKGROUND AND PURPOSE Laparoscopic Heller cardiomyotomy for the treatment of achalasia can be performed safely. The application of this minimally invasive approach has not been reported in Taiwan. This study assessed the results obtained using this new method in Taiwanese patients. METHODS From January 1998 to December 2000, we recruited 10 patients (3 men, 7 women; average age 37.3 yr) with...

BACKGROUND An increasing number of elderly patients diagnosed with achalasia are being referred for minimally invasive myotomy. Little data are available about the operative outcomes in this population. The objective of this study was to review our experience with this procedure in an elderly population. METHODS A retrospective review was performed of 51 consecutive patients, 65 years of age ...

Since its first description in 19911, laparoscopic Heller myotomy has been associated with better short-term outcomes and shorter recovery time, compared to open operation. Given this high success rate2, it was soon generally accepted as the procedure of choice for achalasia over the nonsurgical treatment options, such as medical treatment with calcium channel blockers or nitroglycerin, endosco...

BACKGROUND The named primary esophageal motility disorders (PEMDs) are achalasia, diffuse esophageal spasm (DES), nutcracker esophagus (NE), and hypertensive lower esophageal sphincter (HTN-LES). Although the diagnosis and treatment of achalasia are well defined, such is not the case with the other disorders. HYPOTHESIS (1) Symptoms do not reliably distinguish PEMDs from gastroesophageal refl...