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

Video Transcription

Video Summary

The video summarizes a lecture by Yuto Shimomura from Showa University on tips and tricks for Peroral Endoscopic Myotomy (POEM) procedures. Shimomura highlights the importance of pre-operative patient assessment and preparation for a safe and successful procedure. He emphasizes the significance of accurate diagnosis and proper fasting before general anesthesia to minimize complications. Shimomura also discusses the use of antifungal drugs to manage inflamed mucosa and the importance of esophageal cleansing, especially in patients with sigmoid-type achalasia. He describes the critical role of the knife, the TTJ knife, for mucosal incision, and the use of a transparent distal attachment, the super soft hood, for counter traction during dissection. Other essential equipment mentioned includes coagulation forceps and endoclips for hemostasis and mucosal closure. The lecture also covers anesthesia protocols, myotomy techniques, and the double-scope method for controlling the length and direction of the submucosal tunnel. Shimomura provides additional tips and tricks for navigating challenging situations, such as fibrosis or bleeding during the procedure. The lecture concludes with a discussion on postoperative care, including length of hospital stay and pain management.

Asset Subtitle

Shimamura-virtual

Keywords

Peroral Endoscopic Myotomy

pre-operative assessment

general anesthesia

esophageal cleansing

TTJ knife

super soft hood

coagulation forceps

postoperative care