how to

surgical intervention video

POEM (peroral endoscopic myotomy) is an emerging procedure, which has evolved from the era of NOTES. The most cardinal indication for POEM is achalasia of the cardia. Other indications include diffuse esophageal spasm, jackhammer esophagus, and surgically failed cases. 

The steps of POEM include the following: mucosotomy, submucous tunnelling, myotomy, closure of mucosotomy. 

The myotomy is started 2 to 3cm distal to the mucosotomy and is continued to the end of the tunnel at 2 to 3cm distally to the gastroesophageal junction (GEJ). A partial myotomy is most commonly performed by means of careful dissection of circular fibers, hence avoiding longitudinal fibers to prevent entry into the mediastinum. The mucosotomy is then closed to prevent any leakage with the use of endoscopic clips or of an endoscopic suturing device. About the EndoFLIP™ (Endolumenal Functional Lumen Imaging Probe) Imaging System: this is a functional endoluminal imaging probe, which helps in the assessment of gastroesophageal junction distensibility and compliance after the procedure. 

Complications of POEM:

Inadvertent mucosotomy is the most common complication.

Complications due to insufflation (pneumomediastinum, pneumoperitoneum) can be controlled by using carbon dioxide for insufflation. Esophageal leak is the most dreaded complication with rates ranging from 0 to 5.6%. 



LIVE INTERACTIVE SURGERY: POEM for type 2 achalasia and incidental esophageal leiomyoma

CIRURGIA INTERATIVA AO VIVO: POEM para acalasia de tipo 2 e leiomioma esofágico incidental


实时交互式手术：2型POEM贲门失弛缓症与偶发性食管平滑肌瘤


Chirurgie interactive live : technique POEM pour achalasie de type 2 et léiomyome œsophagien découvert fortuitement


LIVE-хирургия: пероральная эндоскопическая миотомия по поводу ахалазии пищевода 2 типа и случайно выявленной лейомиомы пищевода


CIRUGÍA INTERACTIVA EN VIVO: POEM para acalasia de tipo 2 y leiomioma esofágico incidental


CHIRURGIE INTERACTIVE EN DIRECT : technique POEM pour achalasie de type I : technique de tunnelisation avec ballonnet d'extraction biliaire


POEM (PerOral Endoscopic Myotomy) is a therapeutic endoscopic procedure performed for esophageal achalasia by usually using high-definition upper endoscopes. In this video, Dr. Swanström and Dr. Perretta demonstrate the main principles of POEM in a patient with achalasia. An incision is made in the esophageal mucosa and tunneling of the submucosal layer to reach the muscular layer. The myotomy of the selected region is performed and the incision is closed by means of clips.

LIVE INTERACTIVE SURGERY: POEM for type I achalasia: technique of tunnellization with a biliary extraction balloon

实时交互式手术：POEM治疗I型贲门失弛缓症：使用胆道抽取球囊进行tunnellization技术


LIVE-хирургия: Пероральная эндоскопическая миотомия (POEM) по поводу ахалазии кардии I типа: техника туннелизации


CIRUGÍA INTERACTIVA EN VIVO: POEM para acalasia tipo I: técnica de tunelización con balón de extracción biliar


CIRURGIA INTERATIVA AO VIVO: POEM para acalasia tipo I: técnica de tunelização com balão de extração biliar


Peroral endoscopic myotomy (POEM) is the application of esophageal myotomy by utilizing a submucosal tunnelling method. In this video, the POEM procedure was performed for a child with congenital distal esophageal stenosis and with a previous history of cleft palate, cleft lip, and multiple previous dilations with solid food dysphagia. In this video, Dr. Swanström demonstrates the technique and details the principles of POEM.

LIVE INTERACTIVE SURGERY: POEM for congenital esophageal stenosis in a 13-year-old boy

CIRURGIA INTERATIVA AO VIVO: POEM para estenose esofágica congênita em um menino de 13 anos


实时交互式手术：13岁男孩的先天性食管狭窄POEM


CHIRURGIE INTERACTIVE EN DIRECT : technique POEM pour sténose œsophagienne congénitale chez un enfant de 13 ans


CIRUGÍA INTERACTIVA EN VIVO: POEM para estenosis esofágica congénita en un niño de 13 años


LIVE-хирургия: пероральная эндоскопическая миотомия (POEM) по поводу врожденного стеноза пищевода у 13-летнего ребенка


PerOral Endoscopic Myotomy (POEM)

Myotomie endoscopique perorale (POEM)

Пероральная эндоскопическая миотомия (ПОЭМ)
