Minimal Access Surgery (Laparoscopic Cardiomyotomy) for Achalasia Cardia

Background: Primary motor disorder of esophagus is achalasia cardia which is progressive in nature and do not have any definitive cure.Esophageal cardiomyotomy is the palliative method of treatment which forms the backbone of the treatment line of management. Over a period of last few years minimal access surgery is ganing popularity as the primary modality of management for achalasia.We present our review study of laparoscopic cardiomyotomy and discuss the relevant issues.Method: A retrospective analysis was carried out of various studies who presented the large series of patients who underwent Minimal access cardiomyotomy (laparoscopic) at their respected centers.All patient related factors,the surgical techniques,post-operative course and management including follow-up are discussed.Results: Minimal access approach showed less postoperative pain, ileus, less requirement of intravenous nutrition (P < 0.0001) conse-quently hospital stay, interval resuming the normal routine activity were also shorter (5 to 15 for minimal access surgery group versus 10 to 20 days for the open heller cardiomyotomy group (P < 0.0001).Conclusion: Minimal access surgery for achalasia is becoming more and more popular over conventional open cardiomyotomy in view of its equal safety and efficacy with added advantage of less morbidity,mortality and better quality of life.