Desarrollo De Una Nueva Técnica Endoscópica Para El Tratamiento De La Acalasia: Poem (Per-Oral Endoscopic Myotomy)

Abstract

Development of a new endoscopic technique for treatment of achalasia: POEM (Per-Oral Endoscopic Myotomy) Achalasia is the most common primary motor esophageal disturbance. The most recommended surgical treatment is laparoscopic surgical myotomy. In the last years a new endoscopic technique, called Per Oral Endoscopic Myotomy, was developed for the treatment of the disease. Approximately 1.000 patients have been treated using this technique with good results and a low rate of complications. The five critical steps of the technique are elevation of esophageal mucosa, mucosal incision, creation of a submucosal tunnel, myotomy of internal circular muscular fibers of the esophageal wall, extending it to the stomach and closure of the mucosal wound. This article reports the technique and the implementation of an ex vivo swine training model to learn the technique.