PAEA Surgery End Of Rotation (EOR) Practice Exam

What is typically the surgical approach for a myotomy in achalasia treatment?

1. Transabdominal

2. Thoracoscopic

3. Endoscopic

4. Open incision

The correct answer is: Endoscopic

The surgical approach for a myotomy in the treatment of achalasia is primarily endoscopic. This method, known as endoscopic myotomy, is a minimally invasive technique that allows the surgeon to cut the muscle at the lower esophageal sphincter to relieve the obstruction that characterizes achalasia. The endoscopic approach involves the use of specialized instruments and a camera to perform the procedure through the mouth, minimizing recovery time and associated complications compared to more invasive techniques. Endoscopic myotomy specifically targets the abnormal muscle activity resulting from achalasia, making it an effective option for symptom relief. It is also often combined with an anti-reflux procedure, such as fundoplication, to prevent gastroesophageal reflux, which may occur due to the myotomy. While other surgical approaches, such as thoracoscopic or open incision techniques, can also be used for myotomy in some cases, they are less commonly employed today due to the advantages of the endoscopic method, including lower risk and quicker recovery times.