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

Video Transcription

Video Summary

In this video, the speaker discusses the challenges and potential pitfalls of performing per-oral endoscopic myotomy (POEM) for treating achalasia and jackhammer esophagus. The speaker highlights the importance of proper patient selection and the need for personalized myotomy based on the patient's specific motility disorder. They discuss the potential risks of creating an esophageal diverticulum or "bomb" when performing a long myotomy, and recommend a more conservative approach with shorter myotomies. The speaker also mentions the use of functional luminal imaging probe (FLIP) to assess esophageal distensibility and guide treatment decisions. Additionally, they touch on the issue of misdiagnosing other pathologies such as gastroesophageal reflux disease (GERD) or small hiatal hernias as achalasia, and the potential negative impact of performing unnecessary myotomies. The speaker concludes by cautioning against taking a "one-size-fits-all" approach to myotomies and emphasizes the need for ongoing research and better understanding of motility disorders to improve patient outcomes. No credits were mentioned in the video transcript.

Keywords

POEM

achalasia

patient selection

myotomy

esophageal diverticulum

FLIP

misdiagnosis

motility disorders