ASGE Peroral Endoscopic Myotomy (POEM) Pearls to Practice: LIVE and Virtual | July 2022-Shimamura_POEM Procedures tips and tricks case discussion

Shimamura_POEM Procedures tips and tricks case discussion

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This document provides a summary of a presentation on POEM (Peroral Endoscopic Myotomy) procedures, including tips and tricks for successful implementation. The presentation was given by Dr. Yuto Shimamura from the Digestive Diseases Center at Showa University Koto Toyosu Hospital in Tokyo, Japan. <br /><br />The document begins with a section on preparation, which includes the use of a double scope method and tips for preoperative patient assessment, fasting, and esophageal cleansing. It also recommends the use of antifungal drugs in cases of esophageal candidiasis.<br /><br />Next, the document covers the necessary equipment for POEM procedures, including details on the TT Knife J, super soft hood, saline with blue dye, Coagrasper, EZ Clips, and QuickClip Pro. It also mentions the importance of CO2 insufflation and lists the equipment needed in the operating room.<br /><br />The anesthesia section advises on the use of general anesthesia with controlled ventilation and recommends a supine position with intubation in a tilted position to avoid aspiration.<br /><br />The POEM procedure itself is described, including details on the mucosal incision, submucosal tunneling, myotomy, and mucosal closure. Various techniques and tips are provided for each step, including the use of the Triangle TIP of the Knife, the double scope method, and the importance of proper tension and orientation.<br /><br />The document concludes with case discussions and tips for managing difficult situations during the POEM procedure, such as changing the mucosal incision site or length and using snare traction.<br /><br />Overall, the document provides a comprehensive overview of POEM procedures and offers valuable tips and tricks for successful implementation.

Keywords

POEM procedures

tips and tricks

Dr. Yuto Shimamura

preparation

equipment

anesthesia

mucosal incision

submucosal tunneling

myotomy

case discussions