Intraoperative picture of Heller myotomy for the treatment of achalasia
A. The myotomy is created with a laparoscopic myotome. Make this incision relatively shallow. Traction is applied by a grasper through the righthand port.
The myotomy being carried distally, using hook electrocautery. Care must be taken to elevate the muscle fibers away from the mucosa before the electrocautery is applied. The myotomy extends about 5 to 6 cm proximal to the gastroesophageal junction and abo