Undersaline peroral endoscopic myotomy for hypercontractile esophagus

Abstract Text This video illustrates the advantages of undersaline peroral endoscopic myotomy (POEM) in the setting of hypercotractile esophagus. In this disorder the increased motility of the esophagus makes the procedure challenging and raises the risk of mucosal damage. However, by performing undersaline tunneling ithe mucosa is kept away from the muscle layer and the spasms of the esophagus are not perceived. In addition, simultaneous partial myotomy of all encountered muscle rings straightens the axis of the tunnel and relieves potential angulations. In case of bleeding the saline is transiently aspirated, hemostasis is provided and then the tunnel is refilled with saline. Prior to full-thickness myotomy the saline is aspirated in order to diminish the risk of postoperative pleural effusions. In conclusion, we believe that undersaline POEM is a useful tool when intense esophageal contractions are encountered.

Video  http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/21129e15-d9f5-4cf2-aaa6-1cbe20eac40a/Uploads/16849_Undersaline_POEM%203%20min%20ESGE%20Days.mp4

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025