Acalasia do esôfago: miotomia com transiluminação
Esophageal achalasia: myotomy with transillumination
Rev. Col. Bras. Cir; 26 (6), 1999
Publication year: 1999
Laparoscopic techniques have provided a new dimension to correct functional disorders of the esophagus, which has stimulated some investigators to recently report the use of laparoscopic cardiomyotomy in the treatment of esophageal achalasia. Now, a new instrument has been added to the current laparoscopic technique to offer a safer and easier method to procede complete myotomy. After the dissection of the esophagogastric junction, a special catheter is introduced reaching the stomach. It has an illuminated 10cm extremity connected to a light source. Its withdrawal allows to visualize every muscle circular fiber by transillumination withan improved view provide by the laparoscopic optic system lens. This condition modifies the operative surgeon's attitude offering a better controlled situation over the procedure. The use of transillumination of the esophagogastric junction provides a good identification of the mucosa e submucosa avoiding the risk of esophageal perforation. It also helps to perform a complete myotomy preventing the ocurrence of persistent disphagia in the postoperative period. Cardiomyotomy with parcial fundoplication is possible by videolaparoscopic approach, now made easier with transillumination. This technique is safe and the functional results are similar to those observed in the literature for conventional open procedures, with the obvious advantages of the minimally invasive approach