ASGE Peroral Endoscopic Myotomy (POEM) Pearls to Practice: LIVE and Virtual | July 2022-POEM Procedures Including Tips and Tricks

Video Transcription

Video Summary

In this video, Yuto Shimomura from Showa University discusses his tips and tricks for performing poem procedures. He emphasizes the importance of preoperative patient assessment and adequate preparation for the procedure. Shimomura recommends thorough assessment of the risk of general anesthesia and confirmation of the motility disorder diagnosis before deciding on the poem strategy. He also highlights the need for fasting before general anesthesia to reduce the risk of aspiration. Esophageal cleansing is performed when necessary, particularly for patients with sigmoid type. Shimomura also discusses the equipment and devices used during poem procedures, such as the TTJ knife, space adjuster super soft hood, coagulation forceps, endoclips, and low flow gas tubes. He provides detailed instructions on the steps involved in poem procedures, including mucosal incision, submucosal tunneling, myotomy, and mucosal closure. The importance of maintaining orientation and identifying landmarks such as the left main bronchus is emphasized. Shimomura also introduces the double scope technique, which allows for complete gastric myotomy during poem. He shares tips for difficult situations, including severe fibrosis, bleeding, and abdominal bloating. Shimomura concludes by discussing post-procedure management, recommending hospitalization for several days, and the use of NSAIDs and acetaminophen for pain management. He also highlights the importance of clear visibility and maintaining a high-quality procedure in achieving successful poem outcomes. Overall, this video provides a comprehensive overview of poem procedures and offers valuable tips for performing them effectively. The video is part of a lecture series and was presented by Yuto Shimomura from Showa University as part of a prestigious course. No financial relationships with commercial support were disclosed.

Asset Subtitle

Shimamura-virtual

Keywords

Yuto Shimomura

Showa University

poem procedures

preoperative patient assessment

general anesthesia

esophageal cleansing

mucosal incision

double scope technique