FIGURE 5. Achalasia symptoms before and after laparoscopic Heller myotomy. For comparison purposes, patients were stratified into groups: A (Heller myotomy without fundoplication), B (Heller myotomy with fundoplication for specific indications), and C (Heller myotomy with routine application of fundoplication). Frequency of symptoms was graded 0 (Never) to 10 (Always/every time I eat). Severity of symptoms was graded 0 (Not bothersome) to 10 (Very bothersome). Frequency and severity of symptoms decreased significantly (P < 0.01, paired Student t test) after myotomy, whether or not a fundoplication was applied.