ESOPHAGUS > Laparoscopic Re-Do Heller's Cardiomyotomy

Patient and port position : Patient placed in modified Lloyd Davies position.

Pneumoperitoneum created by veress needle through 10mm supraumbilical skin incision which later on converted into 10mm camera port. 5mm epigastric, 5mm RUQ  and 10mm LUQ ports, 5 mm left anterior axillary line port.

Steps:
Initial step is to visualize all quadrants of peritoneal cavity, liver surfaces, esophageal hiatus.
Adhesiolysis because of previous surgery was done. Left & right crus dissected. Short gastric vessels divided. Lower 7cm of esophagus mobilized. Esophageal myotomy done which extend 5cm above and 2cm distal to GE junction over anterior stomach wall. Divided esophageal muscular wall stitched to left & right crus with 2-0 silk suture. Per Operative endoscopy was also done.