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Laparoscopic Heller Myotomy and Dor Fundoplication for Achalasia

Analysis of Successes and Failures

Marco G. Patti, MD; a Molena, MD; Piero M. Fisichella, MD;

Whang, MD; Hirofumi Yamada, MD; Silvana Perretta, MD; Lawrence W. Way, MD

Arch Surg. 2001;136:870-877.

http://archsurg.ama-assn.org/cgi/content/full/136/8/870

" Dr Patti: As Dr Wolfe mentioned, this is an uncommon operation, so

there is little opportunity for individual surgeons to do enough cases

to master the technical nuances. Considering the known effects of volume

of experience on outcome of operations that involve this much detail, it

could be argued that this operation would best be confined to centers

with a special expertise in laparoscopic esophageal surgery. "

Trends of Heller Myotomy Hospitalizations for Achalasia in the United

States, 1993-2005: Effect of Surgery Volume on Perioperative Outcomes

Authors: Wang, Y. ; Dempsey, T1; Friedenberg, K2;

Richter, E2

Source: The American Journal of Gastroenterology, Volume 103, Number 10,

October 2008 , pp. 2454-2464(11)

Publisher: Blackwell Publishing

http://www.ingentaconnect.com/content/bsc/ajg/2008/00000103/00000010/art00007

" CONCLUSIONS: ... A larger volume of Heller myotomy in a hospital was

associated with better perioperative outcomes in terms of shorter length

of stay and lower total charges. "

Also, you can see a chart from this report, which is not in the

abstract, at:

http://www.pasg.org/documents/08_AM_Presentations/DempseyPresentation.pdf

Laparoscopic Esophageal Myotomy for Achalasia: Factors Affecting

Functional Results

Deb S, Deschamps C, MS, Nichols FC 3rd, Cassivi SD, Crownhart BS,

Pairolero PC.

Division of General Thoracic Surgery, Mayo Clinic College of Medicine,

Rochester, Minnesota, USA.

http://www.ncbi.nlm.nih.gov/pubmed/16181839

" CONCLUSIONS: ... The incidence of intraoperative complications

decreases as experience is gained. ... "