The Authors present a retrospective review of their record of cases, characterized by 4 cases of
achalasia in which it was performed a
Heller myotomy with front
fundoplication (Thall) in laparoscopic approach in the period from 2012 to 2019. In paediatric
achalasia, the
laparoscopic Heller myotomy seems to be the best treatment because of its multiple advantages offered by the minimally invasive technique. First of all, thanks to the video-technique, which allows a complete and extended
myotomy, the accuracy of this operation is maximized; moreover, the
post-operative pain is widely reduced, thanks to the minimal dissection and
traction of the tissues; finally, but not negligible, this approach ensures a better aesthetic result than the classic open technique. With regard to the front
fundoplication, the Authors suggest that it is mandatory because, even if it extends the operating time, it ensures a natural protection to the
myotomy herniated mucosa and avoids
gastro-oesophageal reflux, which often occurs after the surgical correction, thus obliging to perform a reoperation.