A novel technical modification for surgical treatment of achalasia: Submucosal injection to facilitate safe oesophagomyotomy

Achalasia is a primary ES motility disorder in which the lower oesophageal sphincter does not relax properly, and there is no peristalsis. Surgical management of this condition is most often performed using the procedure known as oesophagomyotomy; however, this procedure carries a risk of mucosal perforation, which is dangerous to the patient. We propose a technical modification consisting of submucosal hydrodissection so as to perform oesophagomyotomy more safely. The new technique of injecting saline into the submucosal space enables us to part the mucosa and submucosa from the muscularis, making the dissection easier and minimising the risk of damaging the mucosa. In this article, we have described about this technique, basic advantages and limited outcomes of the patients who have underwent into this kind of modification.