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Editorial Board
(Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Tags: Frontmatter Source Type: research

Offshoots of peroral endoscopic myotomy: Submucosal tunneling endoscopic resection, pyloromyotomy, and beyond
Abstract: The emergence of peroral endoscopic myotomy (POEM) marks the rising of a new branch of therapeutic endoscopy. Our group defines it as tunnel endoscopic surgery that includes several novel procedures utilizing a submucosal tunnel as an operating space. In 2010, we developed a new procedure that takes advantage of the submucosal tunneling technique popularized by POEM to achieve complete, full-thickness endoscopic resection of upper gastrointestinal submucosal tumors originating from the muscularis propria layer. Our group coined the acronym STER (submucosal tunneling endoscopic resection) for this procedure. Herei...
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Authors: Quan-Lin Li, Ping-Hong Zhou, Mei-Dong Xu, Ming-Yan Cai, Li-Qing Yao Source Type: research

Starting a peroral endoscopic myotomy program at your institution
Abstract: Starting a peroral endoscopic myotomy (POEM) program can be difficult. There is no substitute for careful planning and execution. Support at every level is required to make a POEM program a reality. There are 5 essential components to start a POEM program: recruiting collaborators, proper clinical training, institutional support, institutional review board approval, and technical/engineering/nursing support. Without these key components, any endeavor to set up a POEM program is less likely to be successful. Having a collaborative, multidisciplinary team is important for success. Adequate preparation and training ...
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Authors: David J. Desilets, John R. Romanelli, David B. Earle Source Type: research

Training for peroral endoscopic myotomy
Abstract: Peroral endoscopic myotomy (POEM) is a novel treatment for achalasia that is based on the principles of a surgical myotomy. POEM emulates an established surgical procedure, namely Heller myotomy, with endoscopic equipment through the mouth. POEM has been rapidly adopted into clinical practice over the past 3 years. It is a technically demanding procedure that is performed by gastroenterologists and surgeons with different training backgrounds. There is growing interest in dedicated training programs for POEM to enhance its safe clinical introduction. Training programs should help participants gain expertise in th...
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Authors: Daniel von Renteln, Melina C. Vassiliou, Thomas Rösch Source Type: research

Extended indications and contraindications for peroral endoscopic myotomy
Abstract: Peroral endoscopic myotomy (POEM) has proven a remarkably efficacious and safe therapy for patients with typical achalasia in preliminary, short-term, and intermediate-term reports. However, less is known about the feasibility and outcomes of POEM in patients with other hypercontractile motility disorders, prior failed conventional treatments, age extremes, end-stage achalasia, or significant comorbidities. We review the literature data regarding extended indications and contraindications of POEM. The scant data from the literature are augmented by extrapolating from data in the laparoscopic Heller myotomy litera...
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Authors: Stavros N. Stavropoulos, Rani Modayil, David Friedel Source Type: research

Peroral endoscopic myotomy safety data
Abstract: The safety profile of a therapeutic procedure is almost more important than its efficacy. This concept is particularly true for those developing procedures, like Peroral Endoscopic Myotomy (POEM), which are supposed to mimic and reproduce what is usually done by a surgical operation that is recognized as the therapeutic gold standard.The first human POEM was performed in 2008 in Japan. Since then, few groups of investigators have begun to perform POEM and have published their preliminary experiences. The published results are encouraging, demonstrating good results of safety and efficacy.Pneumoperitoneum, pneumom...
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Authors: Pietro Familiari, Michele Marchese, Ivo Boskoski, Guido Costamagna Source Type: research

Peroral endoscopic myotomy outcomes: Efficacy and gastroesophageal reflux disease
Abstract: Achalasia is a well-defined neuromuscular disorder of esophageal swallowing function characterized by a nonrelaxing lower esophageal sphincter (LES) and aperistalsis of the esophageal body. Peroral endoscopic myotomy (POEM) is a flexible endoscopic approach to perform a selective circular myotomy of the distal esophagus and proximal stomach. More than a thousand cases have been performed worldwide. Most early reports on POEM focus on its feasibility and safety. Emerging long-term series have reported excellent subjective and objective outcomes of dysphagia relief for achalasia. With increasing experience, centers...
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Authors: Ashwin A. Kurian, Lee L. Swanström Source Type: research

Peroral endoscopic myotomy periprocedural evaluation: Predicting and measuring outcomes
This article describes the symptom measures and tests of esophagogastric junction physiology that can be used to evaluate patients before, during, and after the POEM procedure. The Eckardt score and other quantitative symptom measures are discussed, as are physiological and diagnostic tests including high-resolution manometry, timed barium esophagram, upper endoscopy, functional lumen imaging probe, and pH monitoring. In combination, these metrics are essential in establishing the diagnosis of achalasia, choosing a treatment modality and predicting its efficacy, and evaluating outcomes after surgery. Additionally, the resu...
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Authors: Ezra N. Teitelbaum, Eric S. Hungness Source Type: research

Peroral endoscopic myotomy for esophageal achalasia: Indication and technique
This article describes the equipment used during POEM as well as the essential steps to have a safe and successful procedure. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Authors: Haruhiro Inoue, Haruo Ikeda, Shin-ei Kudo Source Type: research

Historical notes: The road to peroral endoscopic myotomy
Abstract: Submucosal endoscopy with saftey valve mucosal flap was developed in the animal laboratory of the Mayo Clinic Developmental Endoscopy Unit. This concept, and ultimately clinical technique, was an outgrowth of earlier efforts to improve endoscopic excision of mucosal disease by manipulating the submucosa. The ability of the mucosa to readily separate from the submucosa (delaminate) was the critical observation that was refined into a method transforming the submucosa into a working space while allowing the overlying mucosal flap to serve as a protective barrier. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - July 1, 2013 Category: Gastroenterology Authors: Christopher J. Gostout Source Type: research