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Title
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 Solution 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 Proceed Distally
b. Selective Myotomy of Circular Muscle Fibers
c. Reassess Integrity of Mucosa
5. Closure of Mucosal Incision
6. Post-op Remarks
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Peroral Endoscopic Myotomy (POEM) for Achalasia
Daniel Hashimoto
;
Ozanan R Meireles, MD
;
David Rattner, MD
Massachusetts General Hospital
Tags:
General Surgery
Thoracic Surgery
Main Text
Procedure Outline
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Authors
Daniel Hashimoto
Ozanan R. Meireles, MD
David Rattner, MD
Filmed At:
Massachusetts General Hospital
Article Information
Publication Date
4/25/2022
Article ID
127
Production ID
0127
Volume
2022
Issue
127
DOI
https://doi.org/10.24296/jomi/127