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This is an operation for achalasia of the cardia, a condition in which the muscle in the lower oesophagus fails to relax and therefore hinders the passage of food and fluid into the stomach. Treatment with Botox injections or balloon dilatation of the affected part of the oesophagus can be attempted but are often short-lived and surgery is frequently required as a more lasting solution. Under general anaesthesia, 5 small keyhole incisions are made on the abdomen and laparoscopic instruments are introduced. The lower oesophagus is approached and a lengthwise cut is made in the muscle layer of the lower oesophagus. Care is taken to cut only the muscle layer, leaving the inner lining of the oesophagus intact. As this procedure is often complicated by acid reflux after the operation, a partial or complete fundoplication is also performed at the same time to minimise this. Intake of food should become more comfortable soon after surgery and a near-normal diet can be maintained.

What is a hiatal hernia? A hiatal hernia occurs when the top of your stomach pushes up through an opening in your diaphragm into your chest. Your diaphragm is the muscle barrier that separates your abdominal cavity from your chest cavity. A hernia is when any organ or tissue pushes through a weakness in the tissue barrier that normally contains it. Hernias are common, and hiatal hernias are among the most common types. Hiatal hernias push through a preexisting weakness in your diaphragm — the opening where your esophagus passes through to connect to your stomach. Healthcare providers call this opening the esophageal hiatus, which is where the term, hiatal hernia, or hiatus hernia, comes from. Stress and strain can widen this opening over time. This condition usually develops slowly over many years