Primary Heller’s Myotomy and Belsey Repair for Achalasia of the Esophagus

Esophageal myotomy is a widely accepted treatment in patients with achalasia. However, a definite incidence of reflux and peptic strictures has been described after simple myotomy [1,2]. Therefore, in the last few decades, several types of antireflux procedure have been added to esophageal myotomy to prevent these complications [3–5]. At the First Department of Surgery of the University of Rome “La Sapienza,” the modified Belsey repair has been added to myotomy on a routine basis since 1972.