Surgical options for achalasia
Under Achalasia (“Not slacking”) is understood to be a functional disorder of the esophaguscaused by difficulty swallowing, gagging, belching and / or Chest pain noticeable and has a very restrictive effect on those affected in daily life.
When conservative treatment approaches are incapable of that Achalasia To improve sufficiently, surgery can be resorted to.
Here, the muscles of the lower esophagus are separated lengthways from the outside while protecting the mucous membrane, which means that too narrow a place can be widened.
The classic surgical procedure of achalasia is the so-called extramucous myotomy according to Heller.
The surgeon gets through a large incision in the abdomen (transabdominal) to the esophagus. Since gastroscopy (flexible endoscopy) was introduced, it has become more and more the standard procedure, as this operation is only minimally invasive. This means that the operation is performed laparoscopically, which is much gentler on the patient.
This procedure does not require a large skin incision, only 5 small incisions are needed to gain access to the lower esophagus or the upper one stomach To provide.
The myotomy is then observed with the help of a small camera inserted during this process.
The skin incisions are then sewn up again (Skin seam), covered with a sterile plaster and the patient can be transferred to the recovery room.
The average hospital stay for this operation is about 10 days.
During this period there is a gradual increase in diet, first of all the person concerned is given parenteral infusions (on Intestines over) nourishes.
Then start with small amounts until you are allowed to eat normal again, so as not to overuse the treated area too quickly.
Later, depending on individual needs, follow-up treatment (rehabilitation), which can take up to three weeks. Normally, a patient will then be able to go about his everyday life and his job again without restrictions. Nevertheless, even if he has no symptoms, he should see his doctor about every six months in order to remain under surveillance.
The operation for achalasia is not fraught with high risk because it is only minimally invasive. However, complications such as:
- Wound infections
- Bleeding or
- Problems caused by the Ventilation or the general anesthetic come.
Another complication of this special procedure is the penetration of the mucous membrane, which, however, can usually still be discovered and remedied intraoperatively.
In any case, the surgeon will explain the complications in detail before the upcoming operation.
With a success rate of 80 to 90%, this therapy option can be regarded as very effective. Although it does not treat the cause of the disease but only alleviates its symptoms, only about 5% of treated patients recur later.