[Abstract] [Full Text PDF] (in Japanese / 4948KB) [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 101(4): 357-362, 2000


Feature topic

MODIFIED JEKLER AND LHOTKA OPERATION IN MINIMIZED LAPAROTOMY FOR ACHALASIA

Department of Surgery Institute of Gastroenterology, Tokyo Wemen's Medical University, Tokyo, Japan

Hiroko Ide, Reiki Eguchi, Tsutomu Nakamura, Kazuhiko Hayashi, Ataru Kobayashi, Masaho Oota, Keishi Tanigawa, Kosuke Narumiya

The rationale for surgery in achalasia is to reduce lower esophageal sphincter (LES) pressure and recontruct an antireflux mechanism. Fundopexy as an antireflux procedure after LES myotomy (modified Heller myotomy), called the Jekler and Lhotka method or the Heller and Dor operation, is commonly performed as standard surgery. In our institution, this method has been used since 1982. We have performed the modified Jekler and Lhotha method including long myotomy to confirm complete reduction of LES pressure as measured by intraoperative manometry and fundopexy plus posterior wall fixation to contract the long abdominal esophagus since 1986. Satisfactory results with this procedure have been obtained and reported. Furthermore, we have recently performed this procedure with minilaparotomy. In this review, we describe the modified Jekler and Lhotha method in minimized laparotomy and evaluate this procedure using intraoperative manometry.


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