The esophagogastric junction (EGJ) is exposed for 6 to 8 cm proximally, and the myotomy is performed longitudinally in the anterior esophageal axis using bluntdissection, electric hook, scissors, or the harmonic scalpel. Caution must be taken to avoid injury to the esophageal mucosa, especially when using hook cautery or harmonic scalpel because a burned mucosa may perforate in the postoperative period. The procedure is completed by performing a partial anterior (Dor) or a posterior (Toupet) fundoplication.
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