Clin Endosc.  2016 Jul;49(4):383-386. 10.5946/ce.2015.108.

Double-Scope Peroral Endoscopic Myotomy (POEM) for Esophageal Achalasia: The First Trial of a New Double-Scope POEM

• Hong HJ
• Song GW
• Ko WJ
• Kim WH
• Hahm KB
• Hong SP
• Cho JY

• KMID: 2348259
• DOI: http://doi.org/10.5946/ce.2015.108

Abstract

With the accumulation of clinical trials demonstrating its efficacy and safety, peroral endoscopic myotomy (POEM) has emerged as a less invasive treatment option for esophageal achalasia compared with laparoscopic Heller myotomy. However, the difficulty in determining the exact extent of myotomy, a critical factor associated with the success and safety of the procedure, remains a limitation. Although the various endoscopic landmarks and ancillary techniques have been applied, none of these has been proven sufficient. As a solution for this limitation, the double-scope POEM technique with a second endoscope to assure the exact length of the submucosal tunnel has been applied since 2014. Before double-scope POEM was introduced, the second endoscope was applied only to confirm the accuracy of the procedure. In the present study, we performed double-scope POEM in the treatment of esophageal achalasia through a novel procedure of simultaneous application of the second endoscope to assist in the conventional POEM procedure.

Keyword

Peroral endoscopic myotomy; Esophageal achalasia; Double-scope peroral endoscopic myotomy; Novel approach

MeSH Terms

Endoscopes
Esophageal Achalasia*

Reference

1. Vaezi MF, Richter JE. Diagnosis and management of achalasia. American College of Gastroenterology Practice Parameter Committee. Am J Gastroenterol. 1999; 94:3406–3412.

2. Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010; 42:265–271.

3. Lee BH, Shim KY, Hong SJ, et al. Peroral endoscopic myotomy for treatment of achalasia: initial results of a korean study. Clin Endosc. 2013; 46:161–167.

4. Baldaque-Silva F, Marques M, Vilas-Boas F, Maia JD, Sá F, Macedo G. New transillumination auxiliary technique for peroral endoscopic myotomy. Gastrointest Endosc. 2014; 79:544–545.

5. Stavropoulos SN, Modayil RJ, Friedel D, Savides T. The International Per Oral Endoscopic Myotomy Survey (IPOEMS): a snapshot of the global POEM experience. Surg Endosc. 2013; 27:3322–3338.

6. Grimes KL, Inoue H, Onimaru M, et al. Double-scope per oral endoscopic myotomy (POEM): a prospective randomized controlled trial. Surg Endosc. 2016; 30:1344–1351.

7. Rieder E, Swanström LL, Perretta S, Lenglinger J, Riegler M, Dunst CM. Intraoperative assessment of esophagogastric junction distensibility during per oral endoscopic myotomy (POEM) for esophageal motility disorders. Surg Endosc. 2013; 27:400–405.

8. Parra V, Kedia P, Minami H, Sharaiha RZ, Kahaleh M. Endoscopic optical coherence tomography as a tool to evaluate successful myotomy after a peroral endoscopic myotomy. Gastrointest Endosc. 2015; 81:1251.

9. Kumbhari V, Saxena P, Messallam AA, et al. Fluoroscopy to document the extent of cardiomyotomy during peroral endoscopic myotomy. Endoscopy. 2014; 46 Suppl 1 UCTN:E369–E370.