Which surgical procedure is indicated for achalasia?

Heller myotomy is the surgical procedure indicated for achalasia, which is a condition characterized by the failure of the lower esophageal sphincter (LES) to relax properly during swallowing, leading to difficulty in eating and potential weight loss. This condition is due to the degeneration of the nerves that control the muscles of the esophagus, resulting in both motor dysfunction and increased resting tone of the LES.

The Heller myotomy involves cutting the muscle fibers of the LES to relieve the high pressure and allow food to pass more easily into the stomach. By doing this, the procedure effectively alleviates the symptoms of dysphagia (difficulty swallowing) associated with achalasia.

Other surgical options listed such as Nissen fundoplication, diverticulectomy, and Roux-en-Y gastric bypass do not address the underlying issue of esophageal motility and sphincter relaxation in achalasia. Nissen fundoplication is primarily used for treating gastroesophageal reflux disease (GERD), diverticulectomy is intended for esophageal diverticula, and Roux-en-Y gastric bypass is typically a bariatric surgery aimed at weight loss rather than treating the specific motility disorder associated with achalasia. Therefore, Heller myotomy