ABSTRACT
Indications Laparoscopic Heller myotomy is indicated in operable patients who are candidates
for laparoscopy and who have had diagnostic studies indicating a swallowing disorder consistent with achalasia. Tests that should be performed include a barium swallow (showing the characteristic bird-beak appearance of the narrowed esophagogastric junction [EGJ]), an upper endoscopy to rule out the possibility of a neoplasm (pseudoachalasia), and esophageal manometry that shows absence of peristalsis in the proximal and midesophagus and absence of swallow-induced relaxation of the lower esophageal sphincter (LES), usually with high basal pressure >20 mm Hg.
