Laparoscopic Treatment of Esophageal Achalasia

Esophageal achalasia is a primary motility disorder that is thought to be due to a dysfunction of the enteric nervous system [1]. It is characterized by loss of ganglion cells with degeneration of inhibitory myenteric plexus that innervates the esophageal body and the region of the lower esophageal sphincter (LOS) of unknown origin. It is hypothesized that decreased nitric-oxide synthase leads to a neuronal excitatory/inhibitory imbalance with esophageal aperistalsis, incomplete LOS relaxation in response to swallowing, and increased LOS resting pressures.