ABSTRACT
The aim of treatment of esophageal achalasia is to improve symptoms and restore the transit of saliva and food by reducing the resistance of the lower esophageal sphincter (LES). At present, such an end point can only be reached with pneumatic dilation or with extramucosal myotomy. Proponents of the endoscopic treatment have emphasized that the dilation does not require general anesthesia and can be performed on an outpatient basis, with a quick recovery.1 However, the recent development of minimally invasive surgery has renewed the interest in the surgical therapy of achalasia.2 Today, esophageal myotomy is feasible through the thoracoscopic or the laparoscopic approach and is gaining favor as the initial treatment of choice of the disease. Because of the ease of including an antireflux procedure, the laparoscopic approach is becoming increasingly popular.
