Heller myotomy is the treatment of choice for achalasia and can be easily performed laparoscopically. Intraoperative endoscopy is useful for distention and transillumination of the distal esophagus and for confirmation of complete relaxation of the lower esophageal sphincter as the surgeon extends the myotomy onto the cardia. This videotape will illustrate the surgical technique and simultaneous endoscopic appearance.the diaphragm. Extensive pre- and postoperative studies show that the lower esophageal sphincter pressure has been restored to normal in 74 patients tested postoperatively. Endoscopy with retroflexed view of the valve shows restoration of a grade I or normal gastroesophageal valve in all cases.