Laparoscopic cardiomyotomy is an alternative to Heller's operation for achalasia and oesophageal motility disorders. Although still not widely accepted, both thoracic and abdominal approaches have been used.
The abdominal approach involves sequentially, division of the peritoneum over the oesophagus, mobilization of the right and left margins of the oesophagus, and exposure of 5cm of oesophagus below the phreno-oesophageal membrane. After identification of the anterior vagus nerve, a vertical myotomy is performed lateral to it along the oesophagus.
Perforation is a complication.
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