Per Oral Endoscopic Myotomy (POEM)

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Swedish Thoracic Surgery / First Hill

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Per oral endoscopic myotomy (POEM) is a procedure used in the treatment of achalasia and other swallowing disorders of the esophagus.

Achalasia is a disorder of the esophagus that causes patients to have trouble eating food and drinking liquids. It happens when the nerves in the esophagus don’t work as they should and the lower esophageal sphincter remains closed when it should open to allow food to pass into the stomach.

How is the per oral endoscopic myotomy procedure performed?

A flexible tube called an endoscope is passed through the mouth and into the esophagus. The endoscope allows doctors to see the inside surfaces of the esophagus and stomach.

During the POEM procedure, a small knife is passed through a channel in the endoscope and used to cut through the inner lining of the esophagus to expose the muscles below the lining. The doctor will then insert the endoscope between these layers. This allows the surgeon to create space to see the muscle layers of the lower esophageal sphincter and upper part of the stomach. By cutting these muscles with the knife, the tightness in the lower esophageal sphincter is resolved allowing food to pass through the area.

How long is a per oral endoscopic myotomy?

On average, 1.5-2 hours.

How long is the hospital stay after a per oral endoscopic myotomy?

Hospital stays vary, but most individuals stay overnight.

What are the benefits of per oral endoscopic myotomy?

The benefits include no incisions in the chest or abdomen, and a shorter hospital stay and downtime after the procedure.

What are the risks of per oral endoscopic myotomy?

Because each individual’s condition is different, this procedure does have some risks including:

  • Bleeding
  • Pneumothorax (air in the space between the lungs and the chest wall)
  • Pneumoperitineum (air in the peritoneal cavity)

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