“An Odyssey of Third Space Endoscopy”—from Entry into the Tunnel to Entry into the Peritoneal Cavity

Abstract

The last decade has seen the growth of a completely new and exciting entity called the third space endoscopy (TSE) that has brought about a paradigm shift in the way we manage various disorders of the gastrointestinal tract. The journey started with per oral endoscopic myotomy (POEM) for achalasia cardia and within a decade the concept has been exploited to its best potential for disorders including submucosal tumor resection, pyloromyotomy for gastroparesis, complete division of septum without the risk of perforation in diverticular diseases of esophagus, restoration of esophageal lumen in long strictures, restoration of bowel movement in Hirschsprung’s disease, and then taking the concept to the next level of pure NOTES (natural orifice transluminal endoscopic surgery) by entering the peritoneal cavity and performing fundoplication. This review will discuss the history of TSE with brief discussion about the various applications and what has been achieved till present.

Keywords

third space - per oral endoscopic myotomyfundoplication - robotic - endoscopy

• References

• 1 Sumiyama K, Tajiri H, Gostout CJ. Submucosal endoscopy with mucosal flap safety valve (SEMF) technique: a safe access method into the peritoneal cavity and mediastinum. Minim Invasive Ther Allied Technol 2008; 17 (06) 365-369
• 2 Pasricha PJ, Hawari R, Ahmed I. et al. Submucosal endoscopic esophageal myotomy: a novel experimental approach for the treatment of achalasia. Endoscopy 2007; 39 (09) 761-764
• 3 Inoue H, Minami H, Satodate H, Kudos E. First clinical experience of submucosal endoscopic esophageal myotomy for esophageal achalasia with no skin incision. Gastrointest Endosc 2009; 69 (05) AB122
• 4 Inoue H, Minami H, Kobayashi Y. et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy 2010; 42 (04) 265-271
• 5 Xu M-D, Cai M-Y, Zhou P-H. et al. Submucosal tunneling endoscopic resection: a new technique for treating upper GI submucosal tumors originating from the muscularis propria layer (with videos).. Gastrointest Endosc 2012; 75 (01) 195-199
• 6 Khashab MA, Stein E, Clarke JO. et al. Gastric peroral endoscopic myotomy for refractory gastroparesis: first human endoscopic pyloromyotomy (with video).. Gastrointest Endosc 2013; 78 (05) 764-768
• 7 Bapaye A, Wagholikar G, Jog S. et al. Per rectal endoscopic myotomy for the treatment of adult Hirschsprung’s disease: First human case (with video).. Dig Endosc 2016; 28 (06) 680-684
• 8 Wagh MS, Draganov PV. Per-oral endoscopic tunneling for restoration of the esophagus: a novel endoscopic submucosal dissection technique for therapy of complete esophageal obstruction. Gastrointest Endosc 2017; 85 (04) 722-727
• 9 Li Q-L, Chen W-F, Zhang X-C. et al. Submucosal tunneling endoscopic septum division: a novel technique for treating Zenker’s diverticulum. Gastroenterology 2016; 151 (06) 1071-1074
• 10 Inoue H, Ueno A, Shimamura Y. et al. Peroral endoscopic myotomy and fundoplication: a novel NOTES procedure. Endoscopy 2019; 51 (02) 161-164
• 11 Schlottmann F, Luckett DJ, Fine J, Shaheen NJ, Patti MG. Laparoscopic Heller myotomy versus peroral endoscopic myotomy (POEM) for achalasia: a systematic review and meta-analysis. Ann Surg 2018; 267 (03) 451-460
• 12 Li Q-L, Wu Q-N, Zhang X-C. et al. Outcomes of per-oral endoscopic myotomy for treatment of esophageal achalasia with a median follow-up of 49 months. Gastrointest Endosc 2018; 87 (06) 1405-14e3
• 13 Ponds FA, Fockens P, Lei A. et al. Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia: a randomized clinical trial. JAMA 2019; 322 (02) 134-144
• 14 Tyberg A, Sharaiha RZ, Familiari P. et al. Peroral endoscopic myotomy as salvation technique post-Heller: international experience. Dig Endosc 2018; 30 (01) 52-56
• 15 Nabi Z, Ramchandani M, Chavan R. et al. Peroral endoscopic myotomy in treatment-naïve achalasia patients versus prior treatment failure cases. Endoscopy 2018; 50 (04) 358-370
• 16 Hu J-W, Li Q-L, Zhou P-H. et al. Peroral endoscopic myotomy for advanced achalasia with sigmoid-shaped esophagus: long-term outcomes from a prospective, single-center study. Surg Endosc 2015; 29 (09) 2841-2850
• 17 Chandan S, Mohan BP, Chandan OC. et al. Clinical efficacy of per-oral endoscopic myotomy (POEM) for spastic esophageal disorders: a systematic review and meta-analysis. Surg Endosc 2019; 00
• 18 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 (09) 3322-3338
• 19 Inoue H, Sato H, Ikeda H. et al. Per-oral endoscopic myotomy: a series of 500 patients. J Am Coll Surg 2015; 221 (02) 256-264
• 20 Haito-Chavez Y, Inoue H, Beard KW. et al. Comprehensive analysis of adverse events associated with per oral endoscopic myotomy in 1826 patients: an international multicenter study. Am J Gastroenterol 2017; 112 (08) 1267-1276
• 21 Nabi Z, Reddy DN, Ramchandani M. Adverse events during and after per-oral endoscopic myotomy: prevention, diagnosis, and management. Gastrointest Endosc 2018; 87 (01) 4-17
• 22 Zhang X-C, Li Q-L, Xu M-D. et al. Major perioperative adverse events of peroral endoscopic myotomy: a systematic 5-year analysis. Endoscopy 2016; 48 (11) 967-978
• 23 Wang Y, Liu Z-Q, Xu M-D. et al. Clinical and endoscopic predictors for intraprocedural mucosal injury during per-oral endoscopic myotomy. Gastrointest Endosc 2019; 89 (04) 769-778
• 24 Repici A, Fuccio L, Maselli R. et al. GERD after per-oral endoscopic myotomy as compared with Heller’s myotomy with fundoplication: a systematic review with meta-analysis. Gastrointest Endosc 2018; 87 (04) 934-943.e18
• 25 Tan Y, Lv L, Wang X. et al. Efficacy of anterior versus posterior per-oral endoscopic myotomy for treating achalasia: a randomized, prospective study. Gastrointest Endosc 2018; 88 (01) 46-54
• 26 Werner YB, Costamagna G, Swanström LL. et al. Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years. Gut 2016; 65 (06) 899-906
• 27 Hungness ES, Sternbach JM, Teitelbaum EN, Kahrilas PJ, Pandolfino JE, Soper NJ. Per-oral endoscopic myotomy (POEM) after the learning curve: durable long-term results with a low complication rate. Ann Surg 2016; 264 (03) 508-517
• 28 Ichkhanian Y, Benias P, Khashab MA. Case of early Barrett cancer following peroral endoscopic myotomy. Gut 2019; 68 (12) 2107-2110
• 29 Onimaru M, Inoue H, Bechara R. et al. Clinical outcomes of per-oral endoscopic tumor resection for submucosal tumors in the esophagus and gastric cardia. Dig Endosc 2019; 00
• 30 Lv X-H, Wang C-H, Xie Y. Efficacy and safety of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors: a systematic review and meta-analysis. Surg Endosc 2017; 31 (01) 49-63
• 31 Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L. American College of Gastroenterology. Clinical guideline: management of gastroparesis. Am J Gastroenterol 2013; 108 (01) 18-37, quiz 38
• 32 Mohan BP, Chandan S, Jha LK. et al. Clinical efficacy of gastric per-oral endoscopic myotomy (G-POEM) in the treatment of refractory gastroparesis and predictors of outcomes: a systematic review and meta-analysis using surgical pyloroplasty as a comparator group. Surg Endosc 2019; 00
• 33 Maydeo A, Patil GK, Dalal A. Operative technical tricks and 12-month outcomes of diverticular peroral endoscopic myotomy (D-POEM) in patients with symptomatic esophageal diverticula. Endoscopy 2019; 51 (12) 1136-1140
• 34 Bapaye A, Bharadwaj T, Mahadik M. et al. Per-rectal endoscopic myotomy (PREM) for pediatric Hirschsprung’s disease. Endoscopy 2018; 50 (06) 644-645
• 35 Yeung BPM, Chiu PWY. Application of robotics in gastrointestinal endoscopy: A review. World J Gastroenterol 2016; 22 (05) 1811-1825
• 36 Zhang X, Modayil RJ, Friedel D. et al. Per-oral endoscopic myotomy in patients with or without prior Heller’s myotomy: comparing long-term outcomes in a large U.S. single-center cohort (with videos).. Gastrointest Endosc 2018; 87 (04) 972-985
• 37 Ngamruengphong S, Inoue H, Ujiki MB. et al. Efficacy and safety of peroral endoscopic myotomy for treatment of achalasia after failed heller myotomy. Clin Gastroenterol Hepatol 2017; 15 (10) 1531-15e3
• 38 Kristensen HØ, Kirkegård J, Kjær DW, Mortensen FV, Kunda R, Bjerregaard NC. Long-term outcome of peroral endoscopic myotomy for esophageal achalasia in patients with previous Heller myotomy. Surg Endosc 2017; 31 (06) 2596-2601
• 39 Zhou PH, Li QL, Yao LQ. et al. Peroral endoscopic remyotomy for failed Heller myotomy: a prospective single-center study. Endoscopy 2013; 45 (03) 161-166
• 40 Tang X, Gong W, Deng Z. et al. Feasibility and safety of peroral endoscopic myotomy for achalasia after failed endoscopic interventions. Dis Esophagus 2017; 30 (03) 1-6
• 41 Ling T, Guo H, Zou X. Effect of peroral endoscopic myotomy in achalasia patients with failure of prior pneumatic dilation: a prospective case-control study. J Gastroenterol Hepatol 2014; 29 (08) 1609-1613
• 42 Tan Y, Tang X, Guo T. et al. Comparison between submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric stromal tumors originating from the muscularis propria layer. Surg Endosc 2017; 31 (08) 3376-3382
• 43 Duan T-Y, Tan Y-Y, Wang X-H, Lv L, Liu D-L. A comparison of submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric fundus submucosal tumors. Rev Esp Enferm Dig 2018; 110 (03) 160-165
• 44 Lu J, Jiao T, Zheng M, Lu X. Endoscopic resection of submucosal tumors in muscularis propria: the choice between direct excavation and tunneling resection. Surg Endosc 2014; 28 (12) 3401-3407
• 45 Chai N, Du C, Gao Y. et al. Comparison between submucosal tunneling endoscopic resection and video-assisted thoracoscopic enucleation for esophageal submucosal tumors originating from the muscularis propria layer: a randomized controlled trial. Surg Endosc 2018; 32 (07) 3364-3372
• 46 Chen T, Lin Z-W, Zhang Y-Q. et al. Submucosal tunneling endoscopic resection vs thoracoscopic enucleation for large submucosal tumors in the esophagus and the esophagogastric junction. J Am Coll Surg 2017; 225 (06) 806-816