When the lower esophageal sphincter cannot relax or open upon swallowing it results in the inability to pass food from the esophagus into the stomach. This disease is called achalasia. The diagnosis of this problem is often missed, particularly in its early stages.

That is why careful studies of patients with swallowing difficulties should be done when there is no evidence of a food obstruction by a tumor or stricture. In these patients an esophageal myotomy of the lower sphincter can be done laparoscopically or thorascopically, providing marked relief for patients with this abnormality.

Above: For patients who suffer from achalasia, the inability to pass food from the esophagus into the stomach, an esophageal myotomy is performed. The muscle of the lower sphincter is cut, thereby releasing the obstruction.

Below: A view through the video camera showing the surgical area in performing a myotomy. The diaphragm, which separates the chest from the abdomen, is depressed to visualize the lower esophageal sphincter. The instruments are exposing the muscle of the sphincter in preparation for the myotomy.