Heller Myotomy

Achalasia has two components:

1. The esophagus doesn’t squeeze.
2. The muscle at the bottom of the esophagus (called the “lower esophageal sphincter” or LES) is tight.

During a Heller myotomy, your surgeon makes small incisions in your abdomen and uses tiny robotic instruments to cut into the outer muscle layers of the lower esophageal sphincter, causing it to relax. Your surgeon may also perform a fundoplication, in which a portion of the stomach is wrapped around the lower end of the esophagus to create a new, stronger valve.

After the surgery, you will be on a liquid diet for about one week, before progressing to soft foods, and, eventually, solids. Most people are able to return to work and other activities within 7-10 days. 

Because the Heller myotomy does not address the esophagus’s failure to squeeze, achalasia is not a curable disease. Many people experience relief from their swallowing problems for years. Others have recurrence of their symptoms and need additional procedures, such as a repeat Heller myotomy or a POEM procedure. Your Duke team is committed to your care and will be available at all times for follow up and re-consultation.

Experts in Thoracic Surgery
Duke’s board-certified surgeons have additional fellowship training in thoracic surgery. Together they have performed over 3000 robotic cases for a variety of thoracic conditions over 15 years, including both the Heller myotomy and the POEM procedure.

A Dedicated Esophageal Center 
At Duke, you’ll be cared for by a team of providers including gastroenterologists and thoracic surgeons specializing in esophageal diseases such as achalasia. Managing your care may require regularly scheduled visits for evaluation, testing, and procedures, when needed, as well as follow-up care. Our esophageal specialists work together so you receive the comprehensive care you need.

Committed Care Coordinators
Our care coordinators and social workers help you navigate every aspect of your care, including appointment scheduling, insurance coverage, and access to support resources.