Treatment of achalasia - Recent advances in surgery

Achalasia is an uncommon motility disorder of the esophagus with an uncerta in etiology. Considerable debate exists regarding the most effective treatm ent for long-term relief of symptoms. For decades, pneumatic dilatation has been the primary treatment option, and surgery was reserved for patients w ho required repeated dilations or for those who were not willing to undergo the risk of perforation associated with dilatation. Recently botulinum tox in injection of the lower esophageal sphincter has been shown to provide su bstantial short-term relief from dysphagia; however, its effect only lasts for a short period of time. Recently, minimally invasive surgical technique s have been developed to perform a Heller myotomy effectively with an antir eflux procedure. This has become a primary treatment option for many patien ts. We present a review of the outcome of different therapeutic options of achalasia with a special focus on laparoscopic procedures.