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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Optical coherence tomography after POEM

Amy Tyberg, MD, from Weill Cornell Medical College in New York, New York, USA presents this video case "Endoscopic optical coherence tomography as a tool to evaluate successful myotomy after a peroral endoscopic myotomy." This case describes a 51-year-old woman with achalasia who underwent a per-oral endoscopic myotomy (POEM) with complete resolution of her symptoms …

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Salvage posterior POEM

Nikhil A. Kumta, MD from the Division of Gastroenterology and Hepatology at Weill Cornell Medical College in New York, New York, USA presents this video case, "Salvage posterior peroral endoscopic myotomy." Peroral endoscopic myotomy (POEM) is a highly efficacious endoscopic treatment for achalasia. In this video, we present a patient who had an incomplete clinical …

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