title: Single-incision laparoscopic Heller myotomy and Dor fundoplication for achalasia: report of a case.
abstract: Our objective was to establish the efficiency of single-incision laparoscopic Heller myotomy and Dor fundoplication (SILHD) as treatment for esophageal achalasia. A 58-year-old man underwent SILHD for achalasia. The left triangular ligament was retracted using a suture thread and fixed to the body surface, providing a good operative field at the cardia. We performed a 7-cm long myotomy, extending 2 cm into the gastric wall, using a tissue-sealing device or L-shaped electrocautery. Oral intake resumed on postoperative day 1, and hospital stay was 4 days. No morbidity was observed. Based on our experience, we believe that the SILHD can be performed safely and seems to offer at least short-term benefits for selected patients with esophageal achalasia, when performed by surgeons experienced in laparoscopic and esophageal surgery.
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
authors.forename: Toru
authors.initials: T
authors.lastname: Obuchi
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Baba
authors.forename: Akira
authors.initials: A
authors.lastname: Umemura
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
mesh_terms: D002299:Cardia / Q000601:surgery; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology; D004931:Esophageal Achalasia / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D020127:Recovery of Function; D018570:Risk Assessment; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery