title: Laparoscopic esophagomyotomy for achalasia: how I do it.
abstract: BACKGROUND
  The pathophysiology, diagnosis, and treatment options for achalasia are briefly discussed, followed by a description of the minimally invasive surgical approaches to this disease, as practiced by the authors.
  
  
  CONCLUSIONS
  Laparoscopic myotomy is performed routinely at our institution in the lithotomy position under endoscopic control. The techniques for performing the myotomy, the use of fundoplication, and the adaptation of this approach to use the surgical robot are described. Laparoscopic esophagomyotomy has been highly effective, durable, safe, and widely accepted by patients. There is less data about the robotic approach, but increased degrees of freedom afforded by articulation in the instruments promises finer control and possibly lower perforation rates.
authors.affiliation: Department of Surgery, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9031, USA.
authors.forename: Homero
authors.initials: H
authors.lastname: Rivas
authors.forename: Robert V
authors.initials: RV
authors.lastname: Rege
mesh_terms: D004931:Esophageal Achalasia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D018662:Fundoplication / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D012371:Robotics