Advanced Laparoscopic Techniques at BIDMC

Learn about minimally invasive techniques at BIDMC and how they can improve your recovery.


BIDMC offers the most advanced laparoscopic (minimally invasive) surgical techniques to patients. This helps shorten your hospital stay and enhance your recovery. Our state-of-the-art minimally invasive operating rooms feature special cameras, scopes, lighting and digitally-enhanced equipment.

Our advanced laparoscopic procedures include: 

Heller Myotomy and POEM for Achalasia

Achalasia develops when a muscular valve at the bottom of the esophagus fails to relax properly. The valve, known medically as the lower esophageal sphincter, may block the passage of food and liquids. As a result, patients have trouble eating or even swallowing. BIDMC offers two treatments for achalasia.

Laparoscopic Heller Myotomy

The Heller myotomy has long been the standard treatment for achalasia, offering long-term relief of symptoms. While the patient is under general anesthesia, the surgeon uses a laparoscope to make small incisions in the abdomen. Using miniature instruments, the surgeon makes cuts in the esophageal sphincter so that the muscle relaxes and opens up. The patient usually goes home the next day.

Per Oral Endoscopic Myotomy (POEM)

Per Oral Endoscopic Myotomy, or POEM, is a newer minimally invasive procedure that may be an option for some patients. Using a team approach, a surgeon and gastroenterologist collaborate in this procedure. While the patient is under general anesthesia, the physician inserts an endoscope down the patient’s throat to make a small slit in the esophagus. The physician makes tiny cuts in the sphincter (similar to a traditional myotomy), which weakens the muscle enough to enable it to open. After repairing the slit in the esophagus, the physician removes the endoscope. The patient usually goes home the next day.

Laparoscopic Treatment of Hernias

A hernia is a tear or a weakening of the abdominal wall that left untreated can cause serious intestinal complications. Doctors usually recommend prompt surgical repair as the best treatment for hernias. The laparoscopic approach is preferred, especially if patients have hernias on both sides, or have had recurrent problems with hernias. Patients with very large hernias, however, may do better with the open approach. Today, many surgeons advise laparoscopic approach for single hernias.

With minimally invasive surgery, the surgeon makes a small "keyhole" incision near the navel, and elevates the abdominal wall by inflating the patient's abdomen with carbon dioxide after creating a space with a balloon. A small metal tube-or cannula-is placed through the incision and a tiny camera, or laparoscope, is introduced through the tube, which enables the surgeon to identify the hernia. The surgeon makes two more tiny incisions, placing two additional cannulas to introduce the patch, the stapler and additional instruments necessary to perform the surgery. The surgeon identifies the defect and staples the mesh repair in place. The patient often can go home that day or the next morning.