Single Incision Laparoscopic Hellers Cardiomyotomy With Toupet Fundoplication : Using Conventional Trocars and Instruments

C Palanivelu, P Senthilnathan, P Praveen Raj, R Parthasarthi, P S Rajapandian, V Vaithiswaran, B Vijay. GEM Hospital & Research Centre


Single Incision Laparoscopic Surgery is gaining popularity. Hellers Cardiomyotomy (with or without Fundoplication) is the procedure of choice for treatment of Achalasia Cardia.There are only few reports on Single Incision Hellers Cardiomyotomy. The port devices and specialized instrumentation required add to the cost of the procedure. Here in this video we will be demonstrating our technique of Single Incision Hellers Cardiomyotomy with Toupet Fundoplication using conventional trocars and regular straight instruments.

In this high Definition video, we demonstrate our technique of Single Incision Hellers Cardiomyotomy with Toupet Fundoplication,
The steps are as follows,
– Creation of umbilical flaps by cutting into the umbilicus.
– Creating pneumoperitoneum using a Veress needle
– Placement of one 10mm and two 5 mm trocars at short distance between each other.
– Liver retraction using a novel liver suspension technique using straight needles and a corrugated drain.
– Mobilization of the fundus and the lower end of esophagus after creating the retro esophageal window.
– Myotomy at the level of the LES and proximal esophagus for 5 cms.Closure of the hiatal defect with 1 Ethilon sutures
– Toupet Fundoplication is performed and fixed to the myotomy and wrap anchored to the right crus.


Single incision Heller’s Cardiomyotomy is technically feasible with convention straight laparoscopic instruments and without special access devices.

Session Number: VidTV1 – Video Channel Rotation Day 1
Program Number: V085

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