Per-oral Endoscopic Myotomy

POEM or Peroral Endoscopic Myotomy is a healing endoscopic procedure that is carried out for the treatment of achalasia. The procedure is minimally invasive and it is used for treating the inner muscular layer of the LES which is then subdivided through the submucosal tunnel. This would enable the food and the liquid to pass along smoothly into the stomach which would be otherwise impossible for patients suffering from achalasia.

A tunnel would be created in the course of the procedure and then the POEM would be carried out. It is again done using the endoscope which would mean that there would be no external incisions taking place.

The main reason for performing POEM would be the achalasia which is essentially a disease that is caused owing to impeded esophageal peristalsis along with the collapse of the LES (Lower Esophageal Sphincter).

It is essentially a form of Natural Orifice Transluminal Endoscopic Surgery (NOTES) wherein the abdominal operations are carried out with the endoscope that is passed through the natural orifice like the mouth or the anus, and then into the incision in the stomach like the colon or bladder. This ensures that there are no external incisions on the course of this procedure.

The surgery would be performed when the patient is put under general endotracheal anesthesia. An endoscope would then be inserted into the mouth, then an over-tube would be inserted for constantly removal and insertion of the endoscope. A cut is made in the esophageal mucosa just before the LES, a submucosal tunnel is made using the dissection and electrocautery.

POEM usually takes about 2 hours and it can vary mainly on the characteristics of the physician that is performing the procedure and his /her experience level. Once the patients are discharged, they can go on with their normal life without any issues.