ASGE Peroral Endoscopic Myotomy (POEM) Pearls to Practice: LIVE and Virtual

Video Transcription

Video Summary

In this video, the speaker discusses a case of a patient with end-stage achalasia and a severe sigmoid esophagus who experienced bleeding during a procedure. The speaker describes the use of a T-type hybrid knife to create a tunnel and a retrograde myotomy to control the bleeding. The speaker mentions the challenge of poor visualization and the need for larger coag graspers to control the bleeding. In a desperate attempt to stop the bleeding, a CRE balloon was used for temporary tamponade. The speaker explains the need for additional cautery and myotomy to expose the vessel and control the bleeding. The patient ultimately did well with no further bleeding and had no leak according to an esophagram. The discussion also includes comments from other participants regarding the use of foreign bodies in the tunnel, potential risks, and tips for managing bleeding during the procedure. The video ends with the speaker addressing the topic of myotomy orientation and techniques.

Keywords

achalasia

bleeding

hybrid knife

retrograde myotomy

visualization