Achalasia Surgery
Surgical treatment for achalasia and difficulty swallowing.
Minimally invasive surgery to improve swallowing and relieve achalasia symptoms.
Achalasia Surgery Overview
Achalasia surgery treats a tight lower esophageal muscle that makes it difficult for food and liquids to pass into the stomach.
A robotic Heller myotomy divides this muscle to improve swallowing and reduce symptoms such as regurgitation, chest discomfort, and food becoming stuck in the esophagus. Our team reviews your symptoms, diagnostic testing, previous treatments, and overall health to determine the most appropriate treatment plan.
Conditions Commonly Treated
The Clarus Surgery team diagnoses and treats:
- Trouble swallowing solid foods or liquids
- Regurgitation of undigested food
- A sensation of food becoming stuck
- Chest pain or pressure
- Coughing or choking while eating
- Heartburn-like symptoms
- Unintentional weight loss
- Reduced food intake or poor nutrition
When Surgery Is Recommended
Achalasia surgery may be recommended when:
- Swallowing problems interfere with eating or drinking
- Diagnostic testing confirms achalasia
- Symptoms continue to worsen
- Food frequently becomes trapped in the esophagus
- Nonsurgical treatments do not provide lasting relief
- Regurgitation or choking affects daily life
- Achalasia makes it difficult to maintain a healthy weight
Clarus Surgical Approach
At Clarus Surgery, Heller myotomy may be performed using robotic-assisted techniques. The surgeon uses small incisions and robotic instruments to divide the tight muscle at the bottom of the esophagus while preserving its inner lining. When appropriate, an anti-reflux procedure may also be performed to help reduce acid reflux following surgery.
Have questions about achalasia surgery? Contact our team to schedule an evaluation.
Preparing for Achalasia Surgery
Before surgery, the Clarus Surgery team and anesthesia team provide detailed preparation instructions. General preparation instructions include:
- Do not eat solid foods or consume milk, creamer, gum, candy, or mints after midnight before surgery.
- Follow instructions regarding clear liquids. If no stop time is provided, discontinue clear liquids at midnight.
- Follow medication instructions provided by your anesthesia team, and notify the Clarus Surgery team if you are taking or begin taking any prescription blood thinners before surgery.
- Have a care partner remain in the building during surgery to receive updates from your care team.
- Arrange for a responsible adult to drive you home after surgery and stay with you through the first night after surgery.
Additional preparation instructions may vary depending on your medical history and treatment plan.
Recovery Following Achalasia Surgery
Recovery varies depending on the procedure performed and individual healing.
Diet & Activity Guidelines
Your diet will gradually progress from liquids to soft foods according to the instructions provided by your surgical team. Begin walking shortly after surgery and gradually return to normal activities as tolerated.
Expected Recovery Symptoms
Temporary soreness, bloating, fatigue, and mild swallowing discomfort are common during recovery.
Driving & Daily Activities
Return to normal activities as tolerated. Driving is generally permitted once narcotic pain medication has been discontinued for 48 hours.
Incision Care & Follow-Up Visits
Showering is permitted immediately after surgery. Follow-up is typically scheduled two weeks after surgery.
Post-Surgical Medication Guidance
Following surgery, some patients may require prescription pain medication or other medications to support recovery. Recommendations vary based on the procedure performed, medical history, and individual recovery needs.
Pain Management
Take medications as directed by your care team. Many patients gradually transition from prescription pain medication to over-the-counter pain relief as recovery progresses.
When to Seek Medical Attention
Contact our team immediately if you experience:
- Difficulty breathing
- Severe or worsening chest or abdominal pain
- Inability to swallow liquids
- Persistent vomiting
- Coughing up blood or persistent bleeding
- Fever greater than 101.5°F
- Pain not relieved with medication
- White, yellow, or green drainage from the incision
Small amounts of clear or pink-tinged drainage can be normal during early healing. After-hours calls are answered by the on-call service, which will reach the general surgery provider on call. If you feel your situation is an emergency, call 911 or go directly to your nearest emergency room and ask the treating team to contact us immediately.
Frequently Asked Questions
What is a Heller myotomy for achalasia?
A Heller myotomy is a surgical procedure that divides the tight muscle at the lower end of the esophagus. Relaxing this muscle helps food and liquids pass more easily into the stomach and can reduce difficulty swallowing, regurgitation, and other achalasia symptoms.
How successful is Heller myotomy for achalasia?
Heller myotomy provides long-term symptom improvement for many patients with achalasia. Results vary based on the type and severity of achalasia, previous treatments, and individual anatomy. Your surgeon will discuss the expected outcome based on your condition.
How long is recovery after achalasia surgery?
Recovery varies by patient and surgical approach. Patients generally begin walking soon after surgery and gradually resume daily activities. Diet progresses from liquids to soft foods before regular foods are reintroduced. Your surgical team will provide specific diet and activity instructions.
What can I eat after Heller myotomy surgery?
Patients generally begin with liquids and gradually progress to soft foods as the esophagus heals. Regular foods are reintroduced according to the surgical team’s instructions. Eating slowly, taking small bites, and chewing thoroughly may make swallowing more comfortable.
Can achalasia return after Heller myotomy?
Heller myotomy provides lasting symptom relief for many patients, but swallowing problems can persist or return in some cases. Additional testing or treatment may be needed if symptoms recur. Contact our team if you develop renewed difficulty swallowing, regurgitation, or unexplained weight loss.
