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

Video Transcription

Video Summary

In this video, Dr. Prakash Geowally from Washington University in St. Louis discusses post-poem complications and how to identify and manage them. He explains how he troubleshoots and manages patients who experience symptoms after an esophagogastric myotomy (POEM) procedure. He discusses the different types of esophageal symptoms, including perceptive and transit symptoms, and how to differentiate them. Dr. Geowally also highlights some unique complications related to achalasia, such as esophageal hyposensitivity and idiopathic chest pain.<br /><br />He then discusses the reflux spectrum and presents data comparing the effectiveness of various treatments, such as POM (Peroral Endoscopic Myotomy), pneumatic dilation, and laparoscopic Heller myotomy, in relieving dysphagia and managing reflux symptoms. He emphasizes the importance of personalized treatment based on individual patient needs.<br /><br />Dr. Geowally also discusses evaluation and management of transit symptoms, including the use of barium studies and FLIP (Functional Lumen Imaging Probe) technology. He explains the potential causes of blown out myotomy, when a weakened area of the esophagus balloons out after a myotomy, and discusses potential treatments for this complication. He also mentions other complications and issues that can arise with achalasia, such as massive esophageal dilation, sigmoid esophagus, and possible esophageal cancer.<br /><br />Dr. Geowally concludes by cautioning against overdoing POM and highlights the need for careful evaluation and consideration of symptoms before recommending permanent interventions such as myotomies. He also emphasizes the importance of treating symptoms based on their underlying causes and discussing potential weight-related complications.<br /><br />(Note: This summary is based on the transcript provided and may not fully capture the nuances and details of the video. The summary does not include any additional commentary or analysis provided by Dr. Geowally in the video.)

Asset Subtitle

Gyawali

Keywords

post-poem complications

identify and manage

esophagogastric myotomy

esophageal symptoms

achalasia complications

reflux spectrum

transit symptoms