ASGE DDW Videos from Around the World | 2023-INITIAL INTRAMUSCULAR DISSECTION AS A RESCUE THERAPY DURING POEM FOR ACHALASIA IN A PATIENT WITH SEVERE SUBMUCOSAL FIBROSIS

INITIAL INTRAMUSCULAR DISSECTION AS A RESCUE THERAPY DURING POEM FOR ACHALASIA IN A PATIENT WITH SEVERE SUBMUCOSAL FIBROSIS

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Video Transcription

Video Summary

The transcript describes a video demonstrating a rescue therapy for patients with severe submucosal fibrosis and achalasia. The video showcases a 50-year-old female with long-standing achalasia who underwent peroral endoscopic myotomy (POM). Due to the patient's severe submucosal fibrosis, creating a submucosal tunnel was challenging. To overcome this, the video shows the use of initial intramuscular dissection to establish a submucosal tunnel. The procedure involved careful dissection, creation of an intramuscular tunnel, identification of the submucosal space, expansion of the space, and eventual successful myotomy. The patient experienced improved symptoms and no post-procedure complications. This technique could be considered as a salvage option for patients with severe submucosal fibrosis in long-standing achalasia cases. No credits were mentioned in the transcript.

Asset Subtitle

Honorable Mention

Keywords

rescue therapy

severe submucosal fibrosis

achalasia

peroral endoscopic myotomy

intramuscular dissection