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1. Introduction
2. Creation of Mucosal Incision
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a. Irrigate Gastric and Esophageal Lumen
b. Identify Squamocolumnar Junction
c. Check Orientation of Scope
d. Create Submucosal Cushion
e. Create 1.5 cm Vertical Mucosal Incision
3. Submucosal Tunneling
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a. Use Indigo Carmine/Epinephrine Sol'n to Lift Mucosa Off Circular Muscle Fibers
b. Advance Distally Taking Care not to Injure Mucosa
c. Assess Location of Tunnel
4. Myotomy
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a. Start at Convenient Point and Work Distally
b. Perform Selective Myotomy of Circular Muscle Fibers
c. Re-assess Integrity of Mucosa
5. Closure of Mucosal Incision
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a. Use Clips to Close Incision
6. Debrief
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Peroral Endoscopic Myotomy (POEM) for Achalasia
David Rattner, MD
,
Ozanan R Meireles, MD
,
Daniel Hashimoto
Massachusetts General Hospital
Tags:
General Surgery
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Authors
David Rattner, MD
Ozanan R Meireles, MD
Daniel Hashimoto
Filmed At:
Massachusetts General Hospital
Article Information
Publication Date
N/A
Article ID
127
Production ID
0127
Volume
N/A
Issue
127
DOI
https://doi.org/10.24296/jomi/127