44-year lady presented to MITR hospital out-patient department with complaints of difficulty in swallowing more to solids than liquids, heartburn, and weight loss since few months. Symptoms got worsen gradually.
She was evaluated by Dr. Amit Gharat, Medical Gastroenterologist with an esophago-gastro-duodenoscopy (OGD scopy / upper GI scopy) and observations was difficulty in negotiating lower esophagus. She was further evaluated with esophageal manometry which showed non relaxing lower esophageal sphincter with poor esophageal peristalsis. Diagnosis was made of Achalasia cardia.
She was evaluated for surgery – advantages and disadvantages of open and laparoscopic surgeries discussed. Patient opted for laparoscopic surgery. Preoperative blood investigations, Xray Chest, ECG were done and medical fitness was taken. Pre surgery, anaesthesia evaluation was also done. One day prior to surgery, the lady was admitted in the hospital and prepared for surgery.
Under general anaesthesia, laparoscopic heller myotomy procedure (release of muscle at the lower end of oesophagus) performed through four incisions – two measuring 0.5 cm and 2 measuring 1 cm.
Patient was started on liquids after 6 hours and progressed to full liquids by 2nd day at the time of discharge.
On follow up, she is tolerating soft diet with relief of symptoms.