Endoscopic Peroral Myotomy (POEM)
"This treatment frankly improves the results previously obtained with other endoscopic techniques in patients with achalasia and, in addition, achieves clinical results similar to those obtained with traditional surgery".
DR. JOSE MARÍA RIESCO LÓPEZ PERSON IN CHARGE. DIGESTIVE DEPARTMENT
What is POEM?
Endoscopic Peroral Myotomy (POEM) is a new endoscopic technique that allows to treat the motor pathologies of the esophagus, especially achalasia, in a less invasive way and with a fast recovery.
By means of a gastroscopy, the specialist accesses the esophagus through the mouth to make an incision (myotomy) in the muscular layer of the esophageal wall. This section helps the esophagus to relax again in order to solve the symptoms reported by the patient.
This minimally invasive procedure, which offers results similar to conventional surgery, makes it possible for patients to eat normally, also eliminating chest pain and food regurgitation, thus improving the quality of life of the patients.
The Endoscopy Unit of the Clinic in Madrid incorporates this procedure into its therapeutic options to offer the patient the most appropriate treatment for his or her case.
Do you need us to help you?
When is the POEM indicated?
Difficulty swallowing, chest pain or food regurgitation are some of the symptoms suffered by those who suffer from motor pathologies of the esophagus, being achalasia the most common one. A disorder that prevents the passage of food into the stomach due to a malfunctioning of the esophagus, which is not capable of musculature to push the food or to completely relax the valve (inner esophageal sphincter) that separates it from the stomach.
The POEM technique is considered the procedure of choice for these patients since it is a less invasive treatment with a better recovery than the other therapeutic alternatives.
Furthermore, due to its more direct access to the esophagus, it is especially indicated in those cases that require a longer than usual myotomy.
Most frequent indications of this technique:
- Esophageal motor pathologies.
- Symptomatic esophageal diverticula.
- Tumors of the wall of the digestive tract.
Do you have any of these diseases?
May be improved with endoscopic peroral myotomy (POEM)
How is endoscopic myotomy performed?
In peroral endoscopic myotomy (POEM), the esophagus is accessed by means of a traditional gastroscopy, unlike conventional surgery which does so through the abdominal wall. The esophagus is made up of four layers: mucosa (the innermost), submucosa, muscular and adventitious (the outer).
In these motor pathologies, the layer responsible for the dysfunction is the muscular one, so the objective is to intervene on it. With this technique, access is gained from inside the esophagus by making a small incision in the mucosa and injecting a liquid into the second layer (submucosa) to create a tunnel that allows access to the upper portion of the stomach in addition to the muscular layer. Once there, the required incision is made in the muscle.
Once this excision is made, the muscle stops causing these abnormalities and returns to normal. In other words, the lower esophageal sphincter is able to relax when food passes through it and, at the same time, the esophagus can move (peritaltism) to facilitate the advancement of food.
This minimally invasive technique does not require any incision in the abdominal wall, so the recovery process is faster for the patient.
Usually, the patient is admitted 24-48 hours and starts with a progressive diet plan. On the first day, the patient does not take any food yet and it is not until the second day that he or she begins to drink liquids.
Afterwards, a soft diet is followed for a week until he can resume a normal diet.
Where do we do it?
The Department of Digestive
of the Clínica Universidad de Navarra
The Digestive Department of the Clinica Universidad de Navarra is composed of a multidisciplinary team of specialists who are experts in the diagnosis and treatment of diseases of the digestive tract.
Our objective is that each diagnosis be carefully established and the treatment plan adjusted to each patient.
Why at the Clinica?
- Medical specialists who are national references.
- Specialized nursing team.
- Endoscopy Unit and High Risk Digestive Tumor Prevention and Consultation Unit to offer the best care to our patients.