Comment on the Article: 'The Use of Rigiflex Pneumatic Balloon Dilator during Laparoscopic Heller's Myotomy in Patients with Achalasia: A Novel Technical Method and Its Surgical Outcomes'

摘要

To the Editor: We have read with interest the article "The use of Rigiflex pneumatic balloon dilator during laparoscopic Heller's myotomy in patients with achalasia: a novel technical method and its surgical outcomes," by Bostanci EB et al., published in the November 2018 issue of this Journal. The use of a Rigiflex balloon, gently inflated and deflated during laparoscopic Heller myotomy, is certainly a useful adjunct that helps greatly in performing a complete myotomy and minimizes the risk of perforation. However, this is hardly a new technique. When first introducing laparoscopic Heller-Dor technique in 1993, our group also highlighted this "trick," which was subsequently used in every single Heller myotomy which was performed and that we repeatedly described.This particular maneuver was derived from the open laparotomic technique in use in our group when a Foley catheter was usually introduced across the cardia through a small gastro-stomy. It is also strange the authors did not quote any of these, otherwise highly cited, publications.