Peroral Endoscopic Myotomy for Primary Esophageal Achalasia

Inclusion Criteria:

1. Patients of both sexes aged over 18 years old

2. Patients who have signed the informed consent form before any study related procedure

3. Primary achalasia of the cardia with Eckardt score > 3

4. Non sigmoid achalasia or S1 sigmoid type achalasia at barium meal Rx study

5. ASA score (American Society of Anaesthesiologists) 1 or 2

6. Patients affiliated to a social security health system

Exclusion Criteria:

1. Patients with age less than 18 years old

2. Patients without discernment with legal protection

3. Patients who will not be able to abide with study follow-up as judged by theinvestigator

4. Patients which cannot provide a written informed consent

5. Patient refusing to participate in the study, without informed consent

6. Pregnant or breastfeeding women, women in fertile age for procreation withoutefficient contraception, and/or positive serum βHCG test

7. Concomitant participation in other clinical trial

8. S2 sigmoid type primitive achalasia of the cardia

9. Pseudo-achalasia (esophageal carcinoma),

10. History of Barrett's esophagus with or without dysplasia, malignant tumors of theesophagus

11. History of esophageal strictures, systemic sclerosis

12. History of esophageal varices

13. History of endoscopic or surgical therapy of the esophageal achalasia

14. History of inferior endoscopic or surgical esophageal sphincter manipulation (sutures,polymers injection, adhesive bands)

15. History of surgical interventions of the esophagus or stomach (fundoplication,Heller-Dor myotomy, gastric resections, vagotomy with or without gastric drainage)

16. History of congenital of acquired coagulation anomalies: hemorrhagic diseases,hemostasis disturbances (TP < 60%, TCA > 40 seconds, platelets < 60000/mmc)

17. ASA score (American Society of Anaesthesiologists) 3, 4, 5 or 6

18. Cancer, liver, respiratory, renal or heart failure which put the patients in the ASArisk group 3,4,5 or 6.