Achalasia is preferentially treated by esophageal myotomy. We present a potentially more secure technique of myotomy and fundoplication incorporating a three-stitch cardiopexy on the right of the esophagus and a left lateral fixation at the angle of His.
The process of dissection, fixation and repair is described in detail using intraoperative photographs to illustrate each step.
This technique is especially suited to achalasia patients with abnormalities of the hiatal anatomy.
This paper offers an improvement to a well-practiced technique, which is presented in significant detail. It is of particular interest as it may improve outcomes for achalasia treatment thanks to a more secure technique.