A case of recurrent achalasia cardia with sigmoid esophagus managed laparoscopically

Recurrences of symptoms after the surgery for achalasia cardia are not uncommon. There are several causes of recurrences but the early recurrences are thought to be secondary either to incomplete myotomy or late recurrences due to fibrosis after the myotomy or megaesophagus. A laparoscopic approach is a standard method because of the obvious benefits for the patients. The extent of the myotomy and addition of fundoplication are debatable issue in the management of achalasia cardia but evidence suggests that some kind of fundoplication would be necessary after the complete division of lower esophageal sphincter. We present our experience in a case of recurrent achalasia, secondary to incomplete myotomy managed laparoscopically by extended myotomy and a Dors fundoplication.