腹腔镜Hellers Myotomy用于贲门失弛缓症与前基线治疗 - Dr.Muayad Abass Fadhel

                               
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Video shows a surgery of a 55 years old woman complaining of progressive disphagia for 2 years, before the surgery she only tolarate ingest of liquid diet. Seriography showed large diameter of the esophagus, manometry showed hiperconstriction of the inferior esophagus sphincter, that confirmed Idiopatic Achalasia. Laparoscopic Heller Myotomy + Do'r Fundoplication was indicated and performed.
Ultracision and Monopolar Hook were used in the dissection.
During the surgery, an acessory hepatic artery was preserved in the lesser omentum.The dissection of anterior vagus trunk was showed (that avoids vagus injury during the myotomy and during wrap confection). The wrap was done with continuous suture of prolene 2.0. At the end of the surgery no drain left into the cavity.
Pacient started oral water on day #2, liquid diet on day #3, discharged to home day #4.
Oriented to keep liquid diet for the next 4 weeks.
After that, resume normal oral intake, without no complain of disphagia or reflux.