ASGE Endoscopy Live: Management of Achalasia | April 2023-Case Demonstration 2

Video Transcription

Video Summary

In this video, Dr. John Panolfino and Dr. Aziz Adham present a post POEM assessment of a 23-year-old patient with type 1 achalasia. The patient had undergone a POEM procedure six months ago, which included a three-centimeter esophageal myotomy and an additional one-centimeter myotomy into the gastrocardia. The doctors compare the patient's pre and post-POEM assessments, including esophagram, endoflip, and venometry results. The esophagram shows some retention but also indicates recoil of the esophageal body. The patient reports an ECKARD score of zero, indicating improvement in symptoms and motility surveys. The doctors proceed to perform upper endoscopy using endoflip catheter, focusing on the high-pressure zone. They use a 16-centimeter balloon and measure various parameters, including distensibility index and maximal diameter, at different fill volumes. They discuss interpretations and provide insights into the relationship between pressure, diameter, and reflux risk. The video provides a demonstration of the endoflip procedure and concludes with thanks to the Northwestern team. (No credits are mentioned in the video)

Keywords

POEM assessment

type 1 achalasia

esophageal myotomy

esophagram

endoflip procedure