Different surgical techniques for the treatment of achalasia exist, including laparoscopic Heller myotomy. Laproscopic Heller myotomy is the most common approach; it has better short-term outcomes and similar long-term outcomes when compared to open myotomies. Typical clinical symptoms for achalasia include dysphagia combined with weight loss, regurgitation, recurrent bronchopulmonary infection, chest pain, hiccups, and coughing. We perform a laparoscopic Heller myotomy with fundoplication entering through the umbilicus, upper-left quadrant, and upper midline position. We first open the gastro-hepatic ligament and gastrophrenic membrane while preserving the nervus vagus. To complete the myotomy, we dissect a 10 cm longitudinal section of the muscular layer along the proximal and distal plane centralized at the esophagogastric junction. It is crucial at this point to avoid mucosal injury. After ligating the left and right margins of the esophageal muscle layer to the crus, we apply a Thal—fundoplication. We complete the operation using an endoscope for an air test control. Postoperatively we transfer the patient to a peripheral ward with a nasogastric tube which drains by gravity. The patient is allowed clear liquids after 24 h and a soft diet after 2 days if an esophagogram is clear (the emptying of the esophagus and no leakage). We then discharge the patient (2–4 days) and permit a full diet and normal activity after 4 weeks.