{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:42:25Z","timestamp":1787071345826,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Introduction:<\/jats:title>\n Redyspahgia following laparoscopic has been documented with many causative factors. Peroral endoscopic myotomy, botulinum injections and dilatations have been suggested; however, relaparoscopic Hellers has a role to play, not only to correct or extend the myotomy but allows take down of the improper fundal wrap if leading to dysphagia. We studied our series of 18 patients who had to be reoperated for lap hellers cardiomyotomy (LHCM).<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n The retrospective study was done over 15 years of patients presenting with dysphagia operated in the past for LHCM. A total of 18 patients were studied. Eckardt score following the primary surgery >3 were included and thoroughly investigated. The majority had dysphagia as complaints with primary surgery as LHCM.<\/jats:p>\n <\/jats:sec>\n \n Result:<\/jats:title>\n \n 12 out of 18 patients had incomplete initial myotomy, 10 had incomplete extension on cardia, with one requiring epiphrenic diverticulectomy. All other than one were subjected for ReHellers Cardiomyotomy, which was done at 9 o\u2019clock. The mean Eckardt scores were significantly reduced from the values of 6.38 \u00b1 0.74 preoperatively to 2.0 \u00b1 1.67 postoperatively (\n P<\/jats:italic>\n < 0.01). Symptomatic improvement was seen in 88.8% patients with one patient had Eckardt score >6 and denoted as treatment failure. None had any symptoms of reflux.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Laparoscopic redo surgery, although challenging provides excellent outcomes, using standardised steps in experienced hands, along with permitting to tackle multiple contributory causes of dysphagia and hence is safe, feasible and effective treatment option following the failure of index surgical myotomy in surgically fit patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jmas.jmas_10_24","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T07:00:15Z","timestamp":1773385215000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic revisional surgery following failure of primary laparoscopic Heller\u2019s myotomy for achalasia cardia: A single-centre series"],"prefix":"10.4103","author":[{"given":"Sameer Ashok","family":"Rege","sequence":"first","affiliation":[{"name":"Department of General Surgery, Seth G S Medical College, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devashree","family":"Sane","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Seth G S Medical College, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Salvi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Seth G S Medical College, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"R1-20260313","doi-asserted-by":"crossref","first-page":"3050","DOI":"10.3748\/wjg.v18.i24.3050","article-title":"Pathogenesis of achalasia cardia","volume":"18","author":"Ghoshal","year":"2012","journal-title":"World J Gastroenterol"},{"key":"R2-20260313","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1097\/SLA.0000000000002311","article-title":"Laparoscopic Heller myotomy versus peroral endoscopic myotomy (POEM) for achalasia: A systematic review and meta-analysis","volume":"267","author":"Schlottmann","year":"2018","journal-title":"Ann Surg"},{"key":"R3-20260313","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S2468-1253(20)30296-X","article-title":"Efficacy of surgical or endoscopic treatment of idiopathic achalasia: A systematic review and network meta-analysis","volume":"6","author":"Mundre","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"R4-20260313","doi-asserted-by":"crossref","first-page":"e3001","DOI":"10.1097\/MD.0000000000003001","article-title":"Surgery or peroral esophageal myotomy for achalasia: A systematic review and meta-analysis","volume":"95","author":"Marano","year":"2016","journal-title":"Medicine 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the reliability and construct validity of the Eckardt symptom score as a measure of achalasia severity","volume":"30","author":"Taft","year":"2018","journal-title":"Neurogastroenterol Motil"},{"key":"R9-20260313","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1001\/archsurg.142.11.1093","article-title":"Persistent and recurrent achalasia after Heller myotomy: Analysis of different patterns and long-term results of reoperation","volume":"142","author":"Gockel","year":"2007","journal-title":"Arch Surg"},{"key":"R10-20260313","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1136\/gut.50.6.765","article-title":"Timed barium oesophagram: Better predictor of long term success after pneumatic dilation in achalasia than symptom assessment","volume":"50","author":"Vaezi","year":"2002","journal-title":"Gut"},{"key":"R11-20260313","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1007\/s00268-014-2901-8","article-title":"Recurrent symptoms after Heller myotomy for achalasia: Evaluation and treatment","volume":"39","author":"Patti","year":"2015","journal-title":"World J Surg"},{"key":"R12-20260313","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1089\/lap.2017.0499","article-title":"Redo laparoscopic Heller's cardiomyotomy for recurrent achalasia: Is laparoscopic surgery feasible?","volume":"28","author":"Mandovra","year":"2018","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"R13-20260313","first-page":"129","article-title":"Reapplication of myotomy and fundoplication in the surgical treatment of recurrent dysphagia after incomplete myotomy","volume":"53","author":"Serra","year":"1998","journal-title":"Rev Hosp Clin Fac Med Sao Paulo"},{"key":"R14-20260313","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1007\/s11605-021-05041-x","article-title":"Laparoscopic revisional surgery after failed Heller myotomy for esophageal achalasia: Long-term outcome at a single tertiary center","volume":"25","author":"Capovilla","year":"2021","journal-title":"J Gastrointest Surg"},{"key":"R15-20260313","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s11605-019-04264-3","article-title":"Revisional surgery in patients with recurrent dysphagia after Heller myotomy","volume":"24","author":"Smith","year":"2020","journal-title":"J Gastrointest Surg"},{"key":"R16-20260313","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1007\/s004649901117","article-title":"Laparoscopic Heller myotomy relieves dysphagia in achalasia when the esophagus is dilated","volume":"13","author":"Patti","year":"1999","journal-title":"Surg Endosc"},{"key":"R17-20260313","doi-asserted-by":"crossref","first-page":"177","DOI":"10.4103\/jmas.JMAS_94_17","article-title":"What to do when Heller's myotomy fails?Pneumatic dilatation, laparoscopic remyotomy or peroral endoscopic myotomy: A systematic review","volume":"14","author":"Fernandez-Ananin","year":"2018","journal-title":"J 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