He is one of only a few physicians worldwide who can perform a peroral endoscopic myotomy
(POEM), a technique that helps patients with swallowing disorders.
Objective: Achalasia Cardia is treated by Pneumatic balloon dilatation, Heller's Myotomy
and recently, by Peroral Esophagaeal Myotomy
All of the patients of achalasia were treated by Heller's myotomy
Objective: The study was carried out to ascertain the outcome of laparoscopic modified Heller's myotomy
for achalasia cardia and to determine the morbidity associated with it.
We present the case of a patient with achalasia cardia who developed retrograde gastroesophageal intussusception (GEI) after Heller myotomy
or laparoscopic myotomy
, endoscopic therapy i.
He had a history of laparoscopic fundoplication and myotomy
for achalasia ten years ago.
Type of previous abdominal surgery Previous abdominal surgery (n=146) n (%) Appendectomy 68 (47) Abdominal hysterectomy 52 (36) Cholecystectomy 46 (32) Tubal ligation 13 (9) Partial colectomy 13 (9) Caesarean section 8 (5) Bilateral oophorectomy 4 (3) Total colectomy and end ileostomy, open 3 (2) Small bowel resection, open 3 (2) Radical nephrectomy, open 2 (1) Abdominal abscess drainage, open 2 (1) Retroperitoneal lymph node dissection, open 1 (1) Partial nephrectomy (ipsilateral), laparoscopic 1 (1) Vagotomy, open 1 (1) Abdominal aortic aneurysm repair, open 1 (1) Heller myotomy
, open 1 (1) splenectomy (contralateral), open 1 (1) 1 procedure: 86 patients; 2 or more procedures: 60 patients.
with coronoidectomy has also been suggested.
Laparoscopic re-operation for failed Heller myotomy
Upon further questioning, the patient reported a history of achalasia that had been treated with a myotomy
6 years ago.
Surgical options for OSA management depend on the levels of obstruction that include septorhinoplasty, palatal surgery, maxillofacial surgery, hyoid suspension, infrahyoid myotomy
, mandibular advancement, mandibular osteotomy, midline glossectomy, and tracheostomy.