OPERATION: Laparoscopic Heller Myotomy and Dor Fundoplication
ANAESTHETIC: General endotracheal anaesthesia
POSITION: Supine in stirrups, legs abducted, surgeon between legs. Beanbag support. Pneumatic compression stockings. Orogastric tube inserted and removed prior to myotomy.
INDICATION:
Esophageal achalasia. Preoperative assessment: barium swallow [bird beak appearance / sigmoid oesophagus / dilated oesophagus], upper endoscopy [mechanical obstruction excluded], oesophageal manometry [absent peristalsis, incomplete LOS relaxation confirmed]. [Previous pneumatic dilatation / botulinum toxin injection — noted].
PROCEDURE:
WHO Checklist performed. Abdomen prepared and draped.