Esophageal Disorders

Peroral Endoscopic Myotomy (POEM)

Peroral Endoscopic Myotomy – also known as POEM – is a new, minimally-invasive treatment for swallowing disorders, most commonly for achalasia.

What is Peroral Endoscopic Myotomy?

POEM is a minimally-invasive endoscopic treatment for swallowing disorders that has gained popularity in the past couple of years. Originally tested in the early 2000s, Japan saw the first POEM patient in 2008 with it coming to the States only recently. Normally, it takes 1-3 hours to complete and has been seeing more and more success.

At Advanced Surgical & Bariatrics, we’re proud to promote this revolutionary procedure. We’re one of the first practices in the Northeast to offer POEM and look forward to helping many patients going forward.

The Heller Myotomy

Traditionally, achalasia is treated with a Heller Myotomy – a one-time procedure in which the muscles of the esophagus and the esophageal sphincter are cut, releasing tension and allowing patients to swallow normally. Its main drawback, however, is the complicated nature of the surgery and number of incisions needed to perform it correctly and successfully.

The Benefits Of POEM

The Peroral Endoscopic Myotomy takes the Heller procedure and improves upon it. By using an endoscope, the surgeon is able to see inside of the esophagus and perform the surgery without needing to make external incisions. This reduces the complication rate while minimizing patient discomfort and pain. Overall, POEM poses no risk of injury to abdominal organs and patients experience a quicker recovery time.

What to expect from POEM?

Prior to their procedure, patients need to follow a strict 2-day liquid diet and cannot eat or drink anything 12 hours before the surgery. This ensures the esophagus is clear of food products, which could impede the POEM procedure.

During surgery, patients are put under general anesthesia while an endoscope is inserted through the mouth and down the esophagus. The endoscope contains a camera which allows the surgeon to see the esophagus on a nearby monitor as well as an attached blade to perform the surgery. This scalpel creates an initial incision used to reach the esophagus, then cuts and loosens the tightened muscles until regular functionality has returned to the patient. Lastly, the surgeon inserts endoscopic clips to hold the initial incision closed before removing the endoscope.

What is recovery like after surgery?

Thanks to the minimally-invasive nature of POEM, there’s barely any need for recovery post-procedure. Most patients stay overnight at the hospital so their surgeons can make sure there will be no complications.

Patients usually have an x-ray taken the next day to check the esophageal muscle for leaks, then they are prescribed a liquid diet. Finally, they are discharged and sent home to relax and recover. Patients will return 7 to 10 days later as an outpatient for follow-up care and again 3 months post-op for another swallow study to assess esophageal function.

Is POEM safe?

POEM is significantly safer than its predecessor, the Heller Myotomy. However, as with most medical procedures, there may be potential risk for complications. Potential POEM complications include:

  • Sore throat
  • Chest discomfort
  • Esophageal perforation and bleeding

At Advanced Surgical & Bariatrics, we minimize risk by being experts in minimally-invasive procedures, and maintaining the lowest complication rate in New Jersey. This makes us not only the safest practice in the state, but one of the safest practices in the United States!

Every patient has a different experience and unique questions and concerns – that’s why we discuss all the benefits and potential risks of POEM during a consultation. We’re happy to answer any questions you may have and help you achieve better health!

Contact us today!

Don’t continue suffering from achalasia, schedule a consultation with us today. We’re one of the first practices in the Northeast to offer POEM, and we want to help you!

This page was modified on Sep 3, 2020 by Dr. Sadek (Surgeon) of Advanced Surgical & Bariatrics
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