ASGE Peroral Endoscopic Myotomy (POEM) Pearls to Practice: (On-Demand)

Video Transcription

Video Summary

In the video, the speaker discusses his experience and thoughts on POEM (Peroral Endoscopic Myotomy) procedure for treating achalasia. He highlights the importance of careful patient selection and tailoring the myotomy length based on the specific type of achalasia. He mentions that a short myotomy is appropriate for type 2 achalasia, while a longer myotomy may be needed for type 3 achalasia. He notes the potential risks of extended myotomies, which can lead to the development of a "bomb" or functional obstruction at the cruroplasty. The speaker emphasizes the need to avoid unnecessary myotomies and to consider other contributing factors like small hiatal hernias or spastic patterns in the esophagus. He also mentions the importance of incorporating other diagnostic tools like high-resolution manometry and FLIP (functional luminal imaging probe) to aid in the decision-making process. The speaker concludes by acknowledging the learning phase of the POEM procedure and the need for continued evaluation and improvements in patient outcomes. No credits were given in the transcript.

Keywords

POEM

achalasia

myotomy length

type 2 achalasia

type 3 achalasia

risks

cruroplasty

hiatal hernias