1. The shortcoming of laparoscopic esophageal myotomy is the need for a fundoplication. 2. Spascticity can be treated with botox or myotomies . 3. Botox injections cause scarring in the sphincter which may increase the difficulty of later Heller myotomy . 4. Rarely, the myotomy procedure performed is incomplete and projectile vomiting continues, requiring repeat surgery. 5. Marginal myotomy of levator palpebrae muscle can reduce the palpebral fissure height by 2 3 mm. 6. The Heller myotomy is a long-term treatment, and many patients do not require any further treatment. 7. The robotic lateral esophageal myotomy has had the best results to date in terms of ability to eat without reflux. 8. Laparoscopic myotomy cuts the muscle at the 12 o'clock position, resulting in incompetence of the valve and reflux. 9. On the one hand, the myotomy opens the esophagus, while on the other hand, the fundoplication causes an obstruction. 10. Recent understanding of the gastroesophageal antireflux barrier / valve has shed light on the reason for the occurrence of reflux following myotomy .
