TY - CHAP M1 - Book, Section TI - Esophagocardiomyotomy for Achalasia (Heller) A1 - Hinojosa, Marcelo W. A1 - Oelschlager, Brant K. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Colson, Yolonda L. A2 - Jaklitsch, Michael T. A2 - Krasna, Mark J. A2 - Mentzer, Steven J. A2 - Williams, Marcia A2 - Adams, Ann PY - 2015 T2 - Adult Chest Surgery, 2e AB - In 1914, Ernest Heller described the first cardiomyotomy for the treatment of achalasia.1 He described an anterior and posterior myotomy along the gastroesophageal junction (GEJ) using a thoracoabdominal incision. The operation was subsequently modified by Groenveldt and Zaaijer to include only the anterior myotomy. Owing to the morbidity of the open approach, this operation was performed primarily in patients who failed medical management. It was not until the early 1990s with the advent of minimally invasive techniques that minimally invasive esophagocardiomyotomy became a viable first-line therapy. This operation has yielded excellent results, with 90% to 95% of patients receiving durable relief of dysphagia.2-5 At the University of Washington, we converted from a thoracoscopic approach to a laparoscopic Heller myotomy in 1994, and along with most centers, we now consider laparoscopic esophageal myotomy to be an excellent first-line therapy because of the low morbidity, durability, and the high levels of success after minimally invasive esophagocardiomyotomy.3,6–9 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1105839817 ER -