Peroral Endoscopic Myotomy (also known as POEM is a groundbreaking minimally invasive surgical procedure typically utilized to treat Achalasia, a rare condition that impairs the capacity of the esophagus in transferring foods into stomach. This procedure raises the question, what is peroral endoscopic myotomy? Contrary to traditional surgery that is open or laparoscopic that are performed with the mouth with an endoscope. This means there are no incisions on the outside.

Achalasia can cause difficulty swallowing (dysphagia) and chest pain and the regurgitation of food particles that have not been digested. POEM provides long-term relief by attacking the root of the problemthe inability of the lower esophageal muscle (LES) to ease. Since its debut in 2010, POEM has emerged as the most popular treatment for achalasia and other disorders of the esophageal tract.

Why is POEM Performed?

POEM is generally suggested for patients suffering from

Achalasia (all kinds I II I, II, III)
Obstruction to the outflow of the Esophagogastric junction
Diffuse esophageal spasm
Jackhammer Esophagus (spastic conditions)

They all share a common problem: disruption in normal movements of the esophagus’s muscles that can lead to an impairment in swallowing and discomfort. When changes in lifestyle and medication don’t alleviate the discomfort, POEM becomes a viable and long-lasting option.

How is POEM Performed?

The POEM procedure is a combination that comprise an endoscopy along with myotomy (cutting of muscles) and is carried out under general anesthesia by a skilled surgeon or gastroenterologist. Here’s the step-by-step procedure:

Endoscopic Access A flexible endoscope is introduced through the mouth into the esophagus.
Mucosal Incision: A tiny cut is made inside the lining of the esophagus.
Submucosal Tunnel creation The tunnel is formed within the esophagus’s wall that extends down into the lower part of the esophageal muscle (LES).
Myotomy The surgeon cuts the outer circular muscle layer in the LES and, if required the stomach’s upper part.
Closure The entry cut is closed with endoscopic clips.

The entire procedure typically takes between 1 and 2 hours. It results in no visible marks. Patients can drink their fluids 24 hours after surgery and are able to return home in two to three days.

Benefits of Peroral Endoscopic Myotomy

POEM has several advantages over conventional esophageal surgeries.

Minimally Invasive:- There aren’t any cuts on the outside This implies quicker healing, less pain and less risk of developing an infection.
Effective Symptom Relief:- Research has shown that symptoms are relieved in 90%-95 percent of patients suffering from Achalasia following POEM.
Versatile Use:- It is capable of treating any type of Achalasia and can even treat complex or failed cases of previous surgery.
Short Hospital Stay:- The majority of patients are discharged within 2 to 3 days. Most get back to their normal routines within a week.

Contrary to balloon dilation and Botox injections POEM usually offers the long-term solution.

Risks and Potential Complications

Understanding of what is peroral endoscopic myotomy

Although POEM is considered to be safe and safe, as with any surgery, it is not without certain risk factors:

Gastroesophageal reflux disorder (GERD) post-surgery (most often)
Perforation or bleeding
Infection
Acute reaction to anesthesia
The Pneumomediastinum (air within the chest cavity)

To limit the risks Patients are screened thoroughly prior to surgery and closely monitored following surgery. GERD symptoms following POEM can be effectively treated with medication or lifestyle modifications.

Recovery and Aftercare

Hospital Stay

Patients are usually in hospitals for 3 to 5 days to observe.

Diet

Day 1-2: Clear liquids
Day 3 – 5: Full of liquids
After 1 week: Soft foods
Within 2 weeks Return to normal eating habits

Follow-Up

An second procedure called an endoscopy or imaging can be scheduled between 6 and 12 weeks to evaluate the extent of healing. Patients who have a long-term follow-up are advised to look for signs of reflux or an occurrence.

Conclusion

Peroral Endoscopic Myotomy (POEM) is the latest minimally invasive treatment option for achalasia as well as other disorders of the esophageal muscle. With excellent success rates, less time to heal, and fewer risks, POEM has revolutionized the way doctors treat swallowing conditions. If you have problems swallowing, regurgitation or a chest pain that is not explained talk to an gastroenterologist to determine if POEM is the right option for you.