Laparoscopic Re-Do Myotomy for Recurrent Achalasia After Heller-DOR Procedure
Mario Costantini*, Renato Salvador, Lisa Zanatta, Cristina Longo, Elena Finotti, Tiziana Morbin, Giovanni Zaninotto, Ermanno Ancona
Clinica Chirurgica 1, University of Padua, Padova, Italy
Failures of laparoscopic myotomy are usually managed with complimentary dilations. Sometimes, however, a new operation is necessary. as in the case we present. At re-laparoscopy, the myotomy was clearly short on the gastric side. A new myotomy on the right side of the gullet, prolonged for 2 cm on the lesser curvature, was then performed. A partial antireflux wrap completed the operation. With this technique we operated 11 patients (7 were referrals): all were cured from their residual dysphagia, even if GERD symptoms developed in 2. Laparoscopic revision of unsuccessful myotomy is feasible, and should be considered an option in recurrent patients who do not respond to pneumatic dilations.
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