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People with Achalasia often experience difficulty swallowing and vomiting undigested food. Recurrent episodes may cause pneumonia, especially in the elderly. If this condition worsens, weight loss and malnutrition may develop. Pain is infrequent, but heartburn may result due to food caught in the esophagus.

Achalasia can be treated with a minimally invasive operation called a Heller myotomy. This may be done through the chest or laparoscopically. It involves cutting the outer layer of the esophageal muscle so that food will no longer be restricted.

Laparoscopic surgery uses a thin, telescope-like instrument called a laparoscope, which is inserted through a small incision at the navel. The laparoscope is connected to a video camera which projects a view of the operative site onto video monitors located in the operating room. The abdomen is inflated with carbon dioxide to allow surgeon a better view of the operative area. Two or three additional small incisions are made near the laparoscope through which the surgeon inserts specialized surgical instruments. The surgeon uses these instruments to perform the operation. Following the procedure, the small incisions are closed with sutures and covered with surgical tape.

A complete esophageal myotomy requires a chest incision. This may be necessary in very advanced cases. Increasingly, Heller myotomies are done through the abdomen laparoscopically. In this procedure, the muscles of the lower1/3 of the esophagus and upper stomach are divided. Then there appears to be increasing evidence that this may be sufficient to relieve symptoms with a better tolerated procedure.