ASGE Endoscopy Live: Management of Achalasia | April 2023-Case Demonstration 1

Video Transcription

Video Summary

In this video, Dr. Venkat Chawla demonstrates the procedure of peroral endoscopic myotomy (POEM) for the treatment of achalasia type 2 in a young female patient. He describes the patient's symptoms of dysphagia and regurgitation and shows the endoscopic view of the esophagus, which exhibits stasis changes and a tight lower esophageal sphincter. Dr. Chawla outlines his technique for the myotomy, including measurements of the lower esophageal sphincter and the desired length of the myotomy on both the esophageal and gastric sides. He demonstrates the use of an endoflip balloon to measure distensibility before and after the myotomy. Following the myotomy, he performs closure of the mucosal incision using clips. Dr. Chawla addresses questions from the audience about techniques, patient selection, complications, and post-operative management. He explains that most patients can be discharged on the same day as the procedure, but certain factors may necessitate an overnight stay. He also mentions that the goal for distensibility index following the myotomy is an increase of at least three. The video concludes with introductions of the rest of the course faculty.

Keywords

peroral endoscopic myotomy

achalasia type 2

dysphagia

endoscopic view

lower esophageal sphincter

myotomy

distensibility