PER-ORAL ENDOSCOPIC MYOTOMY FOR ESOPHAGEAL ACHALASIA: TIPS AND TROUBLESHOOTING

Abstract

Esophageal achalasia is a benign disease that causes insufficiency of the lower esophageal sphincter and impaired peristalsis of the esophageal body. However, patients with esophageal achalasia have a high degree of distress due to the difficulty in eating, and it is a disease that needs to be treated. Previously, balloon dilatation and Heller myotomy had been used to treat esophageal achalasia. In addition, per-oral endoscopic myotomy (POEM) has been developed. POEM is a minimally invasive treatment using an oral endoscope, and it is able to provide a long-term effect. At present, only a limited number of facilities in Japan are able to perform the POEM procedure. However, the interest in and recognition of esophageal achalasia itself are increasing with the spread of POEM. In this paper, we describe tips and troubleshooting when performing POEM.