Thoracoscopic esophagomyotomy for achalasia

Achalasia is characterized by the absence of peristalsis in the distal two thirds of the esophagus, failure of receptive relaxation of the lower esophageal sphincter, and dysphagia to both solids and liquids. Diagnosis is confirmed by barium swallow esophageal manometry, and flexible endoscopy. Treatment is based primarily on disruption of the lower esophageal sphincter, which can be achieved by forceful dilation of surgical esophagomyotomy. Esophagomyotomy produces relief of symptoms in more than 90% of patients.