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February 1961

The Heller Extramucosal EsophagomyotomyA Technical Aid in the Performance of This Procedure

Author Affiliations

From the Department of Surgery, Marquette University School of Medicine.

Arch Surg. 1961;82(2):331-332. doi:10.1001/archsurg.1961.01300080159018

Since achalasia of the esophagus is a disturbance of the motor function of the entire organ, various measures proposed for relief of this condition are, at best, purely palliative and are directed at the cardioesophageal area which fails to relax normally during deglutition. Of all the surgical procedures proposed and utilized for achalasia, the Heller extramucosal esophagomyotomy is probably the best operation as judged by symptomatic improvement and low incidence of postoperative esophagitis. Failure to obtain satisfactory symptomatic relief of dysphagia and improved esophageal emptying following this operation is, we believe, due at least in part to incomplete division of the circular muscle fibers over the narrowed segment of the lower esophagus. Lateral freeing of the muscular coats of the esophagus to expose the underlying mucosa over a large portion of the circumference of the esophagus at the site of the myotomy as emphasized by Ellis1 is undoubtedly an

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