Heller myotomy (esophagomyotomy) is considered the most effective treatment for achalasia. In this procedure the lower part of the esophagus is cut lengthwise and the lower esophageal sphincter (LES) is cut. Heller myotomy cuts through the outside muscle layers that are causing the esophagus to constrict and squeeze shut, leaving the inner layer intact. A partial fundoplication or "wrap" at the area of the LES is generally added in order to prevent excessive reflux. Heller myotomy is usually performed laparoscopically through small incisions in the abdomen.