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LAPAROSCOPIC REVISIONAL HELLER MYOTOMY WITH GASTROPEXY
Jon Vandenberg
*, Steven Bowers
Mayo Clinic Florida, Jacksonville, FL
A 71-year-old female with achalasia underwent Heller myotomy with Dor fundoplication in 2005 and experienced recurrence of dysphagia in 2022. Workup revealed a dilated distal esophagus with compression from a herniated fundoplication and manometry showing 100% aperistalsis.
We highlight three important aspects of revisional achalasia surgery. First, a high mediastinal dissection is crucial to maximize intraabdominal esophageal length. Second, evaluation of the previous myotomy and its extension, typically distally, may be required. Finally, adjuncts such as gastropexy can be utilized to aid in esophageal straightening and intraabdominal lengthening.
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