ASGE DDW Videos from Around the World | 2025-PER-ORAL PLICATION OF THE ESOPHAGUS (POPE) IN SIGMOID-TYPE ACHALASIA CONSIDERATIONS AND TECHNIQUES FOR AN ORGAN-SPARING APPROACH

PER-ORAL PLICATION OF THE ESOPHAGUS (POPE) IN SIGMOID-TYPE ACHALASIA CONSIDERATIONS AND TECHNIQUES FOR AN ORGAN-SPARING APPROACH

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Video Summary

Peroral plication of the esophagus (POPE) is a minimally invasive alternative for treating sigmoid-type achalasia, characterized by severe esophageal dilation and tortuosity. It offers an organ-sparing approach compared to esophagectomy, particularly after less effective therapies like Heller myotomy. POPE involves endoscopic suturing to reduce esophageal dilation, minimizing complications like aspiration and food pooling. The procedure requires a therapeutic endoscope and careful management to avoid adjacent structure injury. While promising for symptom management in advanced cases, its long-term efficacy remains under investigation. Repeat procedures may be needed, emphasizing a multidisciplinary approach and patient-specific planning.

Asset Subtitle

Isiah Gonzalez

Keywords

POPE

sigmoid-type achalasia

endoscopic suturing

minimally invasive

esophageal dilation