ASGE DDW Videos from Around the World | 2026-U2-POEM- A NOVEL UNDERWATER UNIDIRECTIONAL MYOTOMY TECHNIQUE

U2-POEM- A NOVEL UNDERWATER UNIDIRECTIONAL MYOTOMY TECHNIQUE

Video Transcription

Video Summary

This case series describes <strong>u-square POEM</strong>, a novel underwater, unidirectional myotomy technique for esophageal motility disorders. In four patients, the procedure was performed entirely under saline, eliminating gas insufflation and the submucosal tunneling step. The team found that <strong>Endocut-U</strong> was a practical cutting mode, and a <strong>long ESD knife with a T-shaped tip and strong water jet</strong> worked well underwater. No adverse events occurred, and all patients went home the same day with marked symptom improvement. The technique may reduce gas-related complications and shorten procedure time.

Asset Subtitle

Endoscopy in Action
Submitted by Mouen Khashab

Meta Tag

Concept Per-oral esophageal myotomy

Concept Myotomy

Concept Underwater Saline Immersion

Concept Submucosal Tunneling

Concept Gas-Related Adverse Event

Keywords

u-square POEM

underwater myotomy

esophageal motility disorders

Endocut-U

ESD knife water jet

Per-oral esophageal myotomy

Myotomy

Underwater Saline Immersion

Submucosal Tunneling

Gas-Related Adverse Event