INTRAOPERATIVE MANOMETRY DURING LAPAROSCOPIC OPERATION FOR ESOPHAGEALACHALASIA - DOES PNEUMOPERITONEUM AFFECT MANOMETRY

The effects of pneumoperitoneum on the lower esophageal sphincter (LES ) were evaluated during laparoscopic operation for esophageal achalasi a. Intraoperative manometry was performed in three patients who underw ent laparoscopic cardiomyectomy with Dor's fundoplication and five pat ients who underwent laparoscopic cholecystectomy (LC). The LES pressur e and the length of the high-pressure zone (HPZ) did not change during pneumoperitoneum in either the achalasia and the LC group, In the ach alasia group the LES pressure was sufficiently decreased following com pletion of cardiomyectomy, and the length of the HPZ was found to be s ufficiently long after completion of fundoplication. The postoperative courses of the achalasia patients were uneventful, and they have had no symptoms of achalasia or gastroesophageal reflux since the operatio n. Accordingly, intraoperative manometry during 12 mmHg pneumoperitone um was considered to be available for laparoscopic surgery for esophag eal achalasia.