title: Laparoscopic cardiomyotomy with a Dor patch for achalasia.
abstract: OBJECTIVE
  To evaluate early experience with laparoscopic Heller's cardiomyotomy with placement of a Dor patch for achalasia.
  
  
  METHODS
  A prospective case series.
  
  
  METHODS
  A university teaching hospital.
  
  
  METHODS
  Fourteen patients (5 men, 9 women, median age 47 years) with esophageal achalasia, treated between July 1992 and July 1994.
  
  
  METHODS
  Laparoscopic Heller's cardiomyotomy with a Dor patch.
  
  
  METHODS
  Clinical relief of symptoms, confirmed by esophageal manometry, 24-hour ambulatory pH monitoring and barium-contrast radiography.
  
  
  RESULTS
  Three of the 14 patients required conversion to an open procedure, and 1 underwent early laparotomy for postoperative bleeding. The median operating time was 120 minutes (range from 75 to 210 minutes), and the median duration of hospitalization was 4 days (range from 3 to 18 days). Normal physical activity was resumed after a median of 2 weeks (range from 0.5 to 6 weeks). Symptomatic dysphagia was completely relieved in 12 patients and improved in 2. Only one patient experienced symptoms of reflux postoperatively. Postoperative esophageal manometry (seven patients), 24-hour pH monitoring (five patients) and barium-meal radiography (seven patients) confirmed the clinical results.
  
  
  CONCLUSIONS
  Laparoscopic Heller's cardiomyotomy with a Dor patch provides a viable alternative to open cardiomyotomy and forceful endoscopic dilatation.
authors.affiliation: Royal Adelaide Centre for Endoscopic Surgery, Royal Adelaide Hospital, South Australia.
authors.forename: P C
authors.initials: PC
authors.lastname: Mitchell
authors.forename: D I
authors.initials: DI
authors.lastname: Watson
authors.forename: P G
authors.initials: PG
authors.lastname: Devitt
authors.forename: R
authors.initials: R
authors.lastname: Britten-Jones
authors.forename: S
authors.initials: S
authors.lastname: MacDonald
authors.forename: J C
authors.initials: JC
authors.lastname: Myers
authors.forename: G G
authors.initials: GG
authors.lastname: Jamieson
mesh_terms: D002299:Cardia / Q000601:surgery; D004931:Esophageal Achalasia / Q000601:surgery*; D004947:Esophagus / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications