Myotomy is a surgical procedure that involves cutting a muscle to relieve constriction, often performed in the gastrointestinal or urological systems. The procedure can alleviate symptoms caused by muscle-related functional obstructions, particularly in cases of achalasia, a disorder that affects the esophagus. Myotomies may be performed using open, laparoscopic, or endoscopic techniques, depending on the location and condition being treated. Common types include the Heller myotomy, used to treat esophageal achalasia, and pyloromyotomy, commonly performed in infants with pyloric stenosis.

Indications

Myotomy is indicated in various conditions characterized by muscular constriction that interferes with normal physiological functions. The most common indications include:

Types of Myotomy

There are several types of myotomy procedures:

Surgical Techniques

Myotomies can be performed using different surgical approaches:

Postoperative Care and Recovery

Following a myotomy, patients generally experience improvement in symptoms, though the degree of recovery depends on the underlying condition and surgical approach. For example, after a Heller myotomy, patients often undergo a modified diet and may need follow-up studies such as a barium swallow to ensure effective swallowing. Gastroesophageal reflux may occur, particularly if fundoplication is not performed. Patients are typically monitored for complications, such as bleeding, infection, or mucosal tears, particularly in endoscopic procedures.

Complications

While generally safe, myotomy procedures have potential complications, including: