Peroral endoscopic myotomy with diverticulum resection

Post written by Yohei Nishikawa, MD, from the Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan. For esophageal diverticulum with symptoms, thoracoscopic or laparoscopic surgery is usually performed. We reported a case of an endoscopic esophageal diverticulum resection by applying the peroral endoscopic myotomy (POEM) and POEM + Fundoplication (POEM-F) techniques, …

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Evaluation of sling fibers and two penetrating vessels for guiding extent of the tunnel and myotomy during posterior peroral endoscopic myotomy

Post written by Hugo Uchima, MD, from the Endoscopy Unit, Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, and the Endoscopic Unit, Teknon Medical Center, Barcelona, Spain. In this video, we describe the technical and anatomic endoscopic references to preserve the innermost gastric oblique fibers (sling fibers) during posterior POEM, based on the location …

Continue reading Evaluation of sling fibers and two penetrating vessels for guiding extent of the tunnel and myotomy during posterior peroral endoscopic myotomy

Peroral endoscopic myotomy for achalasia: a prospective multicenter study in Japan

Post written by Hironari Shiwaku, MD, PhD, from the Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan. Peroral endoscopic myotomy (POEM) is a standard treatment for achalasia. The reported efficacy of POEM in the prospective multicenter study by Dr Von Renteln's group was 82%. However, a retrospective multicenter study in Japan reported …

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Peroral endoscopic myectomy: a novel thought to reduce recurrence after previous failed myotomy

Post written by Zaheer Nabi, MD, DNB, from the Asian Institute of Gastroenterology, Hyderabad, India. This video case describes a novel technique of peroral endoscopic myotomy (POEM) in a patient with recurrence of symptoms after Heller’s myotomy. In this case, we performed POEM by posterior route ie, 5 o’clock. After completing myotomy, we performed a …

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Peroral endoscopic myotomy in a patient with failed Heller’s myotomy by use of a novel bipolar radiofrequency device

Post written by Zaheer Nabi, MD, DNB, from the Asian Institute of Gastroenterology, Hyderabad, India. In this video, we demonstrated the use of a new bipolar knife for peroral endoscopic myotomy (POEM) in a case with previous Heller’s myotomy. This knife uses radiofrequency energy for dissection and microwave energy for coagulation. The technique of POEM …

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Greater-curvature POEM with diverticuloseptotomy for the treatment of achalasia in a patient with a large epiphrenic diverticulum

Post written by Ryan Law, DO, from the Department of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA. We present a 93-year-old man with classic symptoms and manometric findings consistent with type III achalasia with an associated large epiphrenic esophageal diverticulum. He underwent an anterior POEM at an outside institution. He presented to …

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“Posterior-like” anterior per-oral endoscopic myotomy

Post written by Georgios Mavrogenis, MD, from the Department of Gastroenterology, Mediterraneo Hospital, Athens, Greece. Endoscopists are free to choose between anterior of posterior based on their preference. Recent data illustrate that posterior POEM is faster and less prone to mucosal injuries. Conversely, some studies have associated anterior POEM with less post-myotomy acid reflux. We …

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Per-oral endoscopic myotomy with endoscopic septum division

Post written by Zaheer Nabi, MD, DNB, from the Asian Institute of Gastroenterology, Hyderabad, India. In this video case, we describe per oral endoscopic myotomy (POEM) in a case of achalasia with large diverticulum at the lower end of esophagus. POEM was performed in the standard fashion. In addition, the septum between diverticulum and submucosal …

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Through one tunnel, POEM, STER, and STED simultaneously operated

Enqiang Linghu from the Department of Gastroenterology, Hepatology and Endoscopy at Chinese PLA General Hospital, Beijing, China presents this video case. The video demonstrated 3 kinds of submucosal tunneling techniques that were simultaneously performed through 1 tunnel in a 53-year-old female patient, namely submucosal tunneling endoscopic resection (STER), submucosal tunneling endoscopic diverticulotomy (STED), and per-oral …

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Intraprocedural fluoroscopy with POEM

Vivek Kumbhari, MD, from the Department of Medicine and Division of Gastroenterology and Hepatology at The Johns Hopkins Medical Institutions in Baltimore, Maryland, USA shares this New Methods article "Intraprocedural fluoroscopy to determine the extent of the cardiomyotomy during per-oral endoscopic myotomy (with video)." One of the major technical challenges in performing per-oral endoscopic myotomy …

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