title: Laparoscopic stapled cardioplasty for end-stage achalasia.
abstract: BACKGROUND
  The standard of care for achalasia is laparoscopic Heller's cardiomyotomy. This procedure achieves satisfactory and long-standing results in over 85 % of patients. However, in 10-15 % of patients, esophageal function will progressively deteriorate, and up to 5 % will develop end-stage achalasia. Options in these difficult patients are limited, and include redo cardiomyotomy, repeat dilatation, and in severe cases, esophagectomy.
  
  
  METHODS
  In this report, we describe an alternate approach, a cardioplasty, which was originally described by Heyrovsky in 1913.
  
  
  RESULTS
  The development of an angulated stapling device now makes this operation feasible by a laparoscopic approach.
  
  
  CONCLUSIONS
  This report highlights our technique for laparoscopic cardioplasty in patients with end-stage achalasia.
authors.affiliation: Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Ewen A
authors.initials: EA
authors.lastname: Griffiths
authors.forename: Peter G
authors.initials: PG
authors.lastname: Devitt
authors.forename: Glyn G
authors.initials: GG
authors.lastname: Jamieson
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Myers
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Thompson
mesh_terms: D000328:Adult; D002299:Cardia / Q000601:surgery*; D004931:Esophageal Achalasia / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017792:Surgical Stapling / Q000295:instrumentation*; D016896:Treatment Outcome