Minimally Invasive Surgery for Achalasia

Clinical Services: Cardiothoracic Surgery (Thoracic Surgery)

Upper East Side
525 East 68th Street, M-404
New York, NY 10065

Mon-Fri 09:00am - 05:00pm

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Fax

646-962-0203

Call

212-746-5166

North Queens
56-45 Main Street, Suite S376
Flushing, NY 11355

Mon-Fri 09:00am - 05:00pm

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Fax

718-670-2762

Call

718-670-2707

Northwest Brooklyn
263 7th Avenue, Suite 4H
Brooklyn, NY 11215

Mon-Fri 09:00am - 05:00pm

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Fax

718-780-6701

Call

718-780-7700

Achalasia affects the muscle of the esophagus. This disorder causes the band separating the stomach from the esophagus to spasm, which can prevent food from reaching the stomach normally. Currently, it is not known what factors cause achalasia.

Patients suffering from achalasia usually complain of intermittent regurgitation (food coming back up into the esophagus from the stomach) and food feeling like it is "sticking" in the esophagus after swallowing.

Expert achalasia treatment at Weill Cornell Medicine

Diagnosis: Achalasia is diagnosed using tests that examine the structure and function of the esophagus. These tests can include:

• Barium swallow: Patients swallow a liquid that will be visible on an X-ray. A series of X-rays are then taken. People with achalasia will often demonstrate abnormal valve relaxation and an absence of normal contractions.

• Esophageal manometry: Pressure in the valve between the esophagus and stomach is measured using a small catheter placed into the esophagus. Patients with achalasia typically have an elevated lower valve pressure and experience failure of the valve to relax when they are swallowing.

• Endoscopy: During this procedure, a small, flexible telescope is passed through the mouth into the esophagus to examine the esophagus.

Treatment: Achalasia can be complex to treat. It is important to seek expert care for this condition.

Medications that relieve the spasm are typically ineffective and can cause numerous side effects. A procedure called “endoscopic balloon dilation” achieves good results in up to 60 percent of patients, but the benefits often do not last. There is also a risk of perforating the esophagus during dilatation, which requires emergency surgery.

Traditional, “open” surgery for achalasia requires a rib-spreading incision to perform an esophageal "myotomy," or splitting of the abnormally thickened esophageal valve. This carries risks of infection and other complications as well as longer recovery periods.

Minimally invasive achalasia treatment: Weill Cornell thoracic surgeons are able to employ a minimally invasive laparoscopic approach to myotomy in most of our achalasia patients.

After laparoscopic myotomy, patients typically stay in the hospital for only two days, they experience minimal postoperative discomfort, and they are able to eat regular food by the time they are ready to leave the hospital.

Why choose Weill Cornell Medicine for achalasia treatment?

Our patients benefit from:

• The most advanced surgical techniques available today

• Our excellent network of medical professionals, including oncologists, gastroenterologists, and pathologists, working with our thoracic surgeons to ensure patients receive truly comprehensive care

• Treatments tailored specifically to our individual patients

• Our record of excellent outcomes — among the best in the nation — with very low rate of complications

• Expertise in operating on patients with other health problems (such as diabetes, kidney problems, or others) and those who are elderly

Our Doctors

FAQ

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FAQ

I am interested in participating in a clinical trial for thoracic conditions. Where can I learn about the current trials at Weill Cornell Medicine?

Learn about our many current trials open to patient participation.

I would like to learn more about my specific condition and treatment options. Which resources do you recommend?

We recommend visiting the Weill Cornell Medicine Cardiothoracic Department website, as well as the National Cancer Institute and the Lung Cancer Research Foundation.

What happens after I schedule my surgery?

Once you and your care team decide that surgery is the best treatment plan for your condition, you will schedule a pre-surgical appointment at M404.

What happens during the pre-surgical appointment?

During your pre-surgical appointment:

• Your nurse practitioner will explain what you can expect for your specific surgery and hospital stay

• Your nurse practitioner will review your current medications

• You will sign a consent form for the surgery and potential blood transfusion (Please note: Most patients do not receive blood transfusions during surgery, but we are required to have you sign this consent form, just in case you do need a transfusion and are not awake at the time to give your consent. ALL blood is stringently tested for HIV, hepatitis, and cytomegalovirus.)

• You have the opportunity to ask questions

• You will receive a small bottle of antibacterial soap

This process generally takes two to three hours.

What do I need to do to prepare for the surgery?

You will be given instructions as to which medications you should stop taking to prepare for surgery.

On the night before your surgery, shower using half of the bottle of antibacterial soap. On the morning of the surgery, before you come to the hospital, shower using the rest of the soap.

Do not eat or drink after midnight the night before your surgery. You may take your medications that the nurse practitioner approved you to take the morning of surgery, with just a small sip of water.

Where should I park for my surgery?

Parking is available in front of the 68th Street circular entrance to the hospital. There are also several parking garages in the immediate area.

Parking is only validated on the day of your hospital discharge, not on the day of your pre-surgical appointment.

What should I bring for my surgery?

Please be sure to bring your:

• Insurance card(s)

• Toiletries

• Pajamas, robe, and slippers

Generally try not to bring too much to the hospital, because you probably won't use a lot of these things and will just have to carry them home.

Please do not bring any jewelry or expensive electronics with you for the first hospital day. Your family and friends are welcome to bring those items once you are awake and in your room.

Where should I go to check in for the surgery?

Please check in at Greenberg 3-West (Same-Day Surgery Unit), which is on the third floor of the Greenberg Pavilion, using the "G" elevators.

If you are the first case, please check in at 6 a.m. If you are the second case, please check in at 10 a.m.

Where should my friends and family members wait during the surgery?

During your surgery, your family and friends should wait in the Ronald O. Perelman Heart Institute Atrium. Please tell them to check in at the front desk so that they can be contacted when your surgeon calls.

If the Ronald O. Perelman Heart Institute Atrium is closed at the time of your surgery, your family and friends may wait in the smaller waiting area right outside the Cardiothoracic ICU (4-West).

There is also a café on the first floor of the hospital, directly opposite the information desk and down the hall from the front door on the left, which is open at all times. This café sells coffee, tea, and a variety of food.

Where can I learn more information about thoracic surgery at Weill Cornell Medicine?

Please see Guide to Lung, Stomach, Medistatial, or Esophageal Surgery.

What does the typical recovery look like? What should I expect?

Pain in and around the incision may last up to several weeks. It is also very common to experience numbness around the incisions as well.

You will be given specific instructions about how to best care for the incisions. It is important to keep the wounds clean; normal soap and water is best for this care.

You can resume driving six weeks after your operation. Your physician will evaluate if you are ready to fly at your follow up appointment.

How long will it take before I can resume my normal routine and activities?

You will likely feel tired for a few days after the operation. We recommend taking short naps and trying to stay awake during the day as long as possible so that you can rest fully at night.

Exercise: Continue to use the incentive spirometer (the blue "ball machine") for the first week or two after you get home, approximately four to five times each day. Two weeks after surgery, you should be doing enough physical activity to stop using the machine.

Try to walk for 20 minutes twice a day when you come home, and slowly increase the frequency and duration of your exercise. You will slowly increase your endurance and energy level.

Diet: For the first one to two months after surgery, eat as much as you can without regard to salt and fat intake. In general, anesthesia will decrease your appetite, so it is important to eat as much as you can during this time to help your body to heal.

If you were on a special diet (such as a low-carbohydrate, diabetic, or kidney diet), continue following this diet after you feel that your appetite has recovered. Your care team will work with you to help determine the best diet to optimize your health.

I have questions about my insurance coverage. Who should I contact?

Please see Insurance Questions or call (212) 746-5161.