What surgical procedure is indicated for patients with symptomatic achalasia?

Heller myotomy is the surgical procedure indicated for patients with symptomatic achalasia. Achalasia is a disorder of esophageal motility characterized by the failure of the lower esophageal sphincter to relax properly, leading to difficulty in swallowing and regurgitation. The primary goal of treatment in achalasia is to alleviate the obstruction caused by the dysfunctional lower esophageal sphincter.

Heller myotomy involves making an incision in the muscular layer of the lower esophagus and the upper stomach, which allows for better passage of food into the stomach by relieving the tightness of the sphincter. This procedure significantly improves dysphagia (difficulty swallowing) in patients with achalasia and has proven effective in long-term symptom relief.

Other procedures listed, such as pyloroplasty and fundoplication, are not appropriate for treating achalasia. Pyloroplasty is designed to facilitate gastric drainage and manage gastric outlet obstruction, which is unrelated to achalasia symptoms. Fundoplication is performed for gastroesophageal reflux disease (GERD) and aims to prevent acid reflux but does not address the primary issue in achalasia. Cholecystectomy is the surgical removal of the gallbladder and has no relevance to treating