LEMT, or Laparoscopic Endoscopic Myotomy, is a surgical treatment for Achalasia. This condition causes the lower esophageal sphincter (LES) to fail to relax, making it difficult for food and liquid to pass into the stomach. Understanding the timeline for the operation and subsequent recovery is a primary concern for patients considering this minimally invasive procedure.
Understanding the LEMT Procedure
Laparoscopic Endoscopic Myotomy is a collective term for specialized, minimally invasive techniques designed to relieve pressure in the lower esophagus. Achalasia is caused by the degeneration of nerve cells, which prevents the muscular valve (sphincter) at the junction of the esophagus and stomach from opening correctly. The procedure’s purpose is to permanently divide the muscle fibers of this sphincter.
The myotomy, or muscle-cutting, can be achieved through a laparoscopic or a purely endoscopic approach. Regardless of the method, the objective is to create a pathway for food to enter the stomach, resolving the primary symptom of dysphagia (difficulty swallowing). Since the procedure avoids large incisions, recovery is faster than traditional open surgery.
Duration of the Operation and Immediate Stay
The time spent in the operating room for a minimally invasive myotomy generally falls within a two- to three-hour window. The exact duration can vary based on the technique used, the extent of the myotomy required, and the patient’s specific anatomical characteristics. The operation is performed under general anesthesia, with the patient closely monitored throughout.
Immediately following the procedure, the hospital stay is brief, reflecting the minimally invasive nature of the myotomy. Most patients are discharged within one to two nights, sometimes even the following day. This short inpatient period allows the medical team to manage initial pain, monitor for post-operative concerns, and ensure the patient is stable before transitioning to home recovery.
Patients are typically started on a clear liquid diet during the hospital stay. A swallow study, such as a barium esophagram, is often performed before discharge to ensure there are no leaks and that the newly opened muscle is functioning as intended. Once the patient tolerates clear liquids without issue, they are cleared to go home and begin the broader recovery process.
The Full Recovery Timeline
Full recovery after Laparoscopic Endoscopic Myotomy is a multi-phase progression extending beyond the initial hospital stay. Most patients can return to light, non-strenuous daily activities, including simple tasks and short walks, within three to five days of the procedure.
Returning to work depends on the occupation’s physical demands. Individuals with desk jobs can typically resume work within one week. For jobs requiring moderate lifting or physical labor, a two- to three-week period is recommended before returning to full duty.
The diet advances slowly from clear liquids to a soft, pureed food regimen, maintained for approximately two to four weeks after surgery. This gradual change allows the newly cut muscle and surrounding tissue to heal without strain. Strenuous activities, such as heavy lifting or intense exercise, should be avoided for four to six weeks to prevent complications. While symptomatic relief is often immediate, the return to a regular diet typically occurs within one to two months.
Longevity of Results
The relief provided by a myotomy is intended to be long-lasting and has demonstrated high durability. Clinical success, defined as a substantial reduction in swallowing difficulty, remains high for many years following the operation. Studies show that success rates often exceed 70% to 80% at the five-year mark, with durability extending up to ten years in some reports (78% to 91%).
A small percentage of patients may experience a recurrence of symptoms over several years, which may necessitate a minor follow-up intervention, such as balloon dilation or a repeat procedure. However, the vast majority of patients can expect the symptomatic relief from the myotomy to be sustained.