What does the surgical procedure of achalasia involve?

Myotomy: Which means cutting of the muscle sphincter at the bottom of the esophagus. A partial "wrap" or anti reflux procedure is usually added.

Lap or Endoscopic: Surgically cutting the muscle fibers of the lower esophagus, valve between the stomach and esophagus and the top of the stomach is usually done through the abdomen with a technique called laparoscopy. There are a half a dozen centers or so in the us performing this procedure endoscopically, without abdominal incisions with a technique called per oral endoscopic myotomy (poem).