VATS Heller Myotomy

Achalasia
#1

Below is a copy of my introduction. Few of us have had VATS myotomy and I thought it deserved its own conversation, for those who have questions. I’ll make it easier to read some day…

Dialation in 2002 w/ Dr. Ippoliti at UCLA.

Great relief for about 6 months, then steady decline until…

VATS Heller Myotomy from Dr. Clark Fuller @ Cedars Sinai, Los Angeles, CA in 2004.
VATS is video-assisted thoracoscopic surgery. Compared to the lap procedure VATS goes in through your ribs, also minimally invasive. Cedars seems to be the only place that has perfected the technique. VATS procedure compared to lap–VATS enables the surgeon to see more of the esophagus, cut further up the esophagus, less into the stomach. That means the fundoplication procedure, common w/ lap, is not necessary usually w/ VATS. Most of us w/ VATS do not take any antacid medication and do not have GERD or reflux. VATS is more invasive, longer hospitalization time, by a day, also about a day longer on stronger medication. Recovery is similar to lap. The team at Cedars feels that the wrap can cause problems after the myotomy in that it can become too tight, which seems common, and also the lap procedure commonly necessitates the need for antacid medication the rest of their life.
All in all, the VATS has been incredibly successful for me. I take no medication, have no reflux and eat everything. Prior to surgery I couldn’t drink water and regurgitated at least 20x a day. I also had significant saliva buildup and had a difficult time with longer conversations because I needed to get rid of the saliva.
I highly recommend Cedars Sinai, however if you aren’t close to Cedars in Los Angeles, then I’d suggest making the trip anywhere to find a HIGHLY specialized esophageal surgeon. Most long term problems in surgery are due to lack of esophageal experience from a surgeon. In general, it is my opinion you need to go to a MAJOR metropolitan area in a teaching environment to find such experience. You have to balance your finances and insurance, but any mistakes made in the first procedures may cause problems for you later, research all you can at first to get to the best possible doctors. I’m guessing, in the US, there are probably only 4 or 5 surgeons that are truely qualified. I wouldn’t make a lap surgeon do a VATS procedure if they aren’t highly skilled, the type of procedure done is not as important as the skill of the surgeon.
I don’t post as much as I used to, many successful patients “burn out” on message boards, and I fear I have also, but I check in every couple of weeks and I’m more than happy to speak with and meet with anyone in the LA area. It is very valuable to actually meet a fellow achalasia sufferer and see hope for the future.
I really do eat everything now, salad, meat, bread everything.

#2

I don't know if you still look at this posting anymore since it has been 5 years since, I was first diagnosed with Achalasia when I was only 19 years old and almost died because at first I thought it was just a virus because I couldn't keep down only certain things first cheese then meet then within 4 months I was like you. I couldn't even keep my own saliva down I lost so much weight from it that it scared allot of people. Then one day I took a shower and passed out I went to my local hospital and they told me that my potassium crashed and they told me had I not come in and I would have thrown up one more time I could have had a heart attack from lack of potassium in my body. So there I was in the hospital and the Dr's had no clue what was wrong with me until one day they put out on the web a description of my illness and finally Robert Wood Johnson of New Brunswick NJ replied and said they have handled a few cases like mine. So they sent me there and sure enough they said I had Achalasia! They said they had only seen it in elderly people and that I was the youngest case they have ever worked on. Well they performed the Vats Heller Myotomy on me and it did work great for a while, but within a year or so time I was having problems again, and so I had to go back in and have them check me out. Well turns out that there was a re-growth of my Cardia Sphincter and some scar tissue that developed so they then went in with a balloon and had to break the sphincter open. great and all I was once again good for a little, but it then started up again well since my dr. was no longer with the hospital and he was the only one that knew how to Handel my situation I was then sent to the University of PA hospital where I ended up having a Lap done. Still to this day I am now 31 I have such bad days I get these bad stabbing pains in my chest and my abdomen because of gas build up so bad it feels like I’m going to burst. I am going to see another specialist Nov 1st in hopes that they can figure something out because the once again the Dr. who performed the Lap is no longer with the University of PA. Please keep your fingers crossed that this will be my final battle with this horrible condition.