ASGE DDW Videos from Around the World | 2025-PER-ORAL ENDOSCOPIC MYOTOMY FOR MANAGEMENT OF HELICAL STENOSIS OF A GASTRIC CONDUIT POST-ESOPHAGECTOMY

PER-ORAL ENDOSCOPIC MYOTOMY FOR MANAGEMENT OF HELICAL STENOSIS OF A GASTRIC CONDUIT POST-ESOPHAGECTOMY

Video Transcription

Video Summary

Post-esophagectomy, a 69-year-old male had gastric conduit dysfunction manifesting as dysphagia and weight loss. Routine interventions failed due to helical stenosis in the gastric conduit. Utilizing an approach akin to that for sleeve gastrectomy stenosis, a tunneled full-thickness endoscopic myotomy was performed. The procedure involved creating a submucosal tunnel and carefully performing myotomy to release the stenosis. Post-procedure, the patient improved significantly, transitioning to solid meals and gaining weight. The case demonstrates that endoscopic myotomy can effectively manage refractory helical stenosis in gastric conduits, offering a less invasive alternative to surgery.

Asset Subtitle

Shirley X. Jiang, Ali Dashti, Cynthuja Thilakanathan, Roberto Trasolini

Keywords

endoscopic myotomy

gastric conduit dysfunction

helical stenosis

post-esophagectomy

submucosal tunnel