Myotomy can be performed as a laparoscopic, thoracoscopic or an open surgery.
- Laparoscopic and thoracoscopic myotomies are minimally invasive procedures. They involve small surgical cuts through which a thin tube-like device is inserted into the body. The device has a tiny camera at one end that enables the surgeon to view the inside of the body and operate. Thus, a large cut is avoided.
- In thoracoscopic myotomy of the lower esophageal sphincter, the surgeon performs the surgery by passing a thin tube-like device called thoracoscope through the patient’s chest.
- A thoracoscopic myotomy requires an anti-reflux procedure to prevent regurgitation. It is more difficult to perform. This problem is not encountered with laparoscopic techniques.
- In a laparoscopic myotomy, the device, called a laparoscope, is passed through the patient’s abdomen
- Laparoscopic myotomy allows better visualization for the surgeon as compared to a thoracoscopic myotomy.
- Myotomies in patients with severe achalasia need more time, which is possible in laparoscopic myotomy because it is a longer procedure than thoracoscopic surgery.
- Long-term outcomes and success rates are higher with laparoscopic myotomies than those with thoracoscopic myotomies.
- Postoperative complications, especially reflux or regurgitation, are higher in a thoracoscopic myotomy as compared to a laparoscopic procedure.
What is an esophageal myotomy surgery?
Esophageal myotomy is a surgical procedure to loosen the tight valve between the food pipe (esophagus) and the stomach. The thick muscle of the lower part of the esophagus and the upper part of the stomach is cut to relieve the difficulty in swallowing (dysphagia). This condition occurs when the lower esophageal sphincter fails to relax properly (achalasia). It is an uncommon disorder of the esophagus characterized by inadequate relaxation of the lower esophageal muscle, and the loss of motility. Achalasia causes difficulty in pushing the swallowed food into the stomach. This is commonly seen in young people, age ranging from teens to 30s, and they present with:
- Dysphagia (difficulty in swallowing) for both solids and liquids at the same time
- Regurgitation (the swallowed food is pushed back into the oral cavity)
- Dry cough
- Chest pain
- Weight loss
An esophageal myotomy surgery provides relief from achalasia by disrupting the muscles of the lower esophageal sphincter to relax the esophagus and allow passage for food.
When will I be able to eat after a myotomy surgery?
You will be able to have liquids on the evening of your operation. You will be then advanced to a soft diet and discharged from the hospital the following day. Your doctor may give you medications to prevent nausea besides painkillers and antibiotics. You will be advised to avoid strenuous activity and heavy lifting for four to six weeks. You may be able to resume normal activities within one to two weeks and a regular diet in two to six weeks after the surgery.
What are the complications of a thoracoscopic and laparoscopic myotomy surgery?
Complications are similar in both thoracoscopic and laparoscopic myotomies, however, certain complications, such as reflux, may be more frequent in case of a thoracoscopic myotomy.
The complications of a myotomy surgery include:
- Esophageal perforation or hole
- Pneumothorax (presence of air between the lungs and the chest wall)
- Nerve injury
- Spleen injury
- Dysphagia (difficulty in swallowing)
- Scarring in the lower part of the esophagus or the upper part of the stomach
- Stricture formation (areas of abnormal narrowing of the esophagus or the stomach)
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Common Medical Abbreviations & Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
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Is Heller Myotomy a Major Surgery?Heller myotomy is a surgical procedure that corrects achalasia, a condition that makes swallowing difficult (dysphagia). Open Heller myotomy involves cutting the outer muscles of the lower end of the esophagus through a large incision in the abdomen. This procedure relaxes the lower esophageal sphincter to improve your swallowing ability.
What Is Laparoscopy Used For?Laparoscopy is a minimally invasive surgery or keyhole surgery that helps diagnose and treat many health conditions. A laparoscope is a thin, flexible tube with a light and small video camera on the end. The tube is put into a small surgical cut made through the abdominal wall near the belly button.