Cardiomytomy for achalasia.The photograph shows the operative field in preparation for a
cardiomyotomy. On view is the left lobe of the liver (L), the apex of the spleen (S), the fundus of the stomach (F) and a tape around the esophagus (E).
The photograph shows the completed cardiomyotomy. The dissection
extends from the apex of the esophageal hiatus (H) to one centimetre
below the cardio-esophageal junction (C). The cut muscle (M) is grossly thickened.
Comment: open cardiomyotomy for achalasia is now uncommon, as the
preferred treatment is laparoscopic cardiomyotomy. In this case the
procedure was undertaken by the open approach only because the patient underwent a simultaneous right hemicolectomy for carcinoma of the ascending colon.
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