Peroral Endoscopic Myotomy (POEM)
Peroral Endoscopic Myotomy (POEM)
POEM is a therapeutic endoscopic procedure. In this method, procedure is conducted through high-definition upper endoscopes.
Indications
Helps in the treatment of following disease:
- Achalasia
- Spastic esophageal disorders resistant to conventional medical therapies (such as nutcracker esophagus, and diffuse esophageal spam).
Pre-operative instructions
Patient should be instructed to follow these things before undergoing POEM:
- Diet restricted to fluids only, 2 days prior to POEM
- Do not eat any liquids or foods for 12 hours before the procedure. It keeps the esophagus clear of food components.
- Inform the doctor about any allergies or history of allergic reaction
POEM Procedure
- Placement of an IV into the vein to allow administration of antibiotics, anaesthesia and fluids.
- Monitoring of pressure by an arterial line.
- An endoscope is passed through the mouth that goes into the esophagus. The therapy starts once endoscope reaches the esophagus.
- A clear image is seen at the monitor that provides assessment of GIT
- Internal lining of the esophagus is incised. Once incised, an endoscope enters the esophagus to expose the muscles.
- The inner muscles near the lower esophageal sphincter are sliced. This is called as myotomy.
- The esophageal incision can undergo closure through standard endoscopic clips.
Post-operative instructions
Patient is required to stay at the hospital or clinic approximately for 2 days. It helps to monitor and examine the patient. Furthermore, intravenous antibiotics are given.