Twenty four patients who underwent laparoscopic Heller without fundoplication had greater improvement in esophageal clearance time than did 71 patients whose procedure included a Dor fundoplication as studied by Finley and colleagues15 there were no significant differences in the symptom scores for dysphagia, regurgitation, or heartburn between the two groups postoperatively.
Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial.
In 2007 an elective laparoscopic Heller myotomy (approximately 5 cm anterior myotomy) with Dor fundoplication was performed without complication.
At surgery, it was clear that the previous myotomy had not extended onto the stomach and therefore did not disrupt the LES as desired, additionally the Dor fundoplication created a secondary esophageal obstruction in an immotile esophagus making food transit impossible.
Laparoscopic Heller myotomy and Dor fundoplication for achalasia: analysis of successes and failures.
We have followed laparoscopic Heller's myotomy (LHM) alone in the early part of the series and later added an anterior partial Dor fundoplication (LHM+DF).
In the later cases Dor fundoplication was added and currently is the standard procedure in our department.
This patient had a Dor fundoplication as a cover for the suture line.
12,13) Fewer complications have been encountered with the Dor fundoplication
compared with other antireflux procedures.
after myotomy for achalasia: useful, unnecessary, or harmful?
Modified Heller myotomy and an anterior Dor fundoplication was done in all (100%) cases.
With short hospital stay and cost effectiveness combination of Heller's myotomy and Dor fundoplication is a formidable option for treatment of achalasia cardia since it can be performed by general surgeons with minimal experience, it does not require lung ventilation.