Laparoscopic Heller Myotomy

Your esophagus is the part of your body that moves food from your mouth to your stomach. When you swallow, muscles in a part of your esophagus called the lower esophageal sphincter (LES) relax to let food into your stomach. If the muscles don't relax like they should, you may have a condition called achalasia. It can be treated with a surgery called laparoscopic Heller myotomy.

During the surgery, the muscles that won't relax are cut. This helps you to swallow.

Tell a health care provider about:

• Any allergies you have.
• All medicines you're taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthesia.
• Any bleeding problems you have.
• Any surgeries you've had.
• Any medical conditions you have.
• Whether you're pregnant or may be pregnant.

What are the risks?

• Infection.
• Bleeding.
• Heartburn.
• Acid reflux.
• A hole or tear in your esophagus. This is often fixed right away with a surgery.
• Allergic reactions to medicines.

What happens before the surgery?

When to stop eating and drinking

Follow instructions from your provider about what you may eat and drink. These may include:

• 8 hours before your surgery
  • Stop eating most foods. Do not eat meat, fried foods, or fatty foods.
  • Eat only light foods, such as toast or crackers.
  • All liquids are okay except energy drinks and alcohol.
• 6 hours before your surgery
  • Stop eating.
  • Drink only clear liquids, such as water, clear fruit juice, black coffee, plain tea, and sports drinks.
  • Do not drink energy drinks or alcohol.
• 2 hours before your surgery
  • Stop drinking all liquids.
  • You may be allowed to take medicines with small sips of water.

If you don't follow your provider's instructions, your surgery may be delayed or canceled.

Medicines

• Changing or stopping your regular medicines. These include any diabetes medicines or blood thinners you take.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take them unless your provider tells you to.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

Surgery safety

• How your surgery site will be marked.
• What steps will be taken to help prevent infection. These steps may include:
  • Removing hair at the surgery site.
  • Washing skin with a soap that kills germs.
  • Taking antibiotics.

General instructions

• If you'll be going home right after the surgery, plan to have a responsible adult:
  • Take you home from the hospital or clinic. You won't be allowed to drive.
  • Care for you for the time you're told.

What happens during the surgery?

• An IV will be inserted into one of your veins.
• You'll be given:
  • A sedative. This helps you relax.
  • Anesthesia. This keeps you from feeling pain. It will make you fall asleep for surgery.
• Small cuts called incisions will be made in your belly. Tools will be put through those cuts.
• A tube will be put into one cut. It will be used to fill your belly with gas. This will make the area easier to see.
• A tube called a laparoscope will be put into another cut. This sort of tube has a camera on the end of it. It will send pictures to a screen in the room.
• The tools will be used to cut the muscles that won't relax.
• Your cuts will be closed with stitches (sutures), skin glue, or tape strips. They may also be covered with a bandage called a dressing.

The procedure may vary among providers and hospitals.

What happens after the surgery?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You'll have an IV until you can drink on your own.
• You may be given medicines to help with:
  • Pain.
  • Nausea and vomiting.