The evolution of the treatment of esophageal achalasia: a look at the last two decades.

Thanks to the development of minimally invasive surgery, the last 20 years have witnessed a revolution in the treatment of benign esophageal disorders, particularly for esophageal achalasia. This has brought a shift in the treatment algorithm of this disease, as today a laparoscopic Heller myotomy with partial fundoplication is considered the primary form of treatment in most Centers in North America. This article reviews the evolution of the treatment of esophageal achalasia during the last two decades, with particular stress on the key technical elements of this operation.