Post written by Shaimaa Elkholy, MD, from the Gastroenterology Division, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

We present here a case of a middle-aged male patient with history of refractory gastroparesis post-surgical fundoplication. Despite using extensive medical treatment of antiemetics and prokinetics, his condition was deteriorating. We performed G-POEM, which is gastric peroral endoscopic myotomy. In G-POEM, we perform a tunnel 5 cm proximal to the pyloric ring, then we cut the pyloric ring, and then closed the tunnel opening with clips. The patient’s symptoms markedly improved, with a drop of his gastroparesis cardinal symptom index and an increase in his body weight.

G-POEM is an application of third space endoscopy, which we can apply on the pyloric ring to relief the pyloric ring spasm. G-POEM is a safe and effective procedure.

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