Abstract
Background
Previous investigators have shown the feasibility of performing an esophageal myotomy using natural orifice translumenal endoscopic surgery (NOTES), but have been unsuccessful at extending the myotomy onto the body of the stomach.
Methods
In a nonsurvival porcine model, the authors used the self-approximating translumenal access technique (STAT) to create a submucosal tunnel in the upper esophagus and to extend it onto the body of the stomach allowing a complete cardiomyotomy.
Results
The STAT approach was successfully used to create a submucosal tunnel and perform a complete myotomy of the gastroesophageal junction without complication.
Conclusions
A complete Heller-type cardiomyotomy can be successfully performed using transesophegeal NOTES.
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References
Ortega JA, Madureri V, Perez L (1980) Endoscopic myotomy in the treatment of achalasia. Gastrointest Endosc 26:8–10
Takes RP, van den Hoogen FJ, Marres HA (2005) Endoscopic myotomy of the cricopharyngeal muscle with CO2 laser surgery. Head Neck 27:703–709
Pasricha PJ, Hawari R, Ahmed I, Chen J, Cotton PB, Hawes RH, Kalloo AN, Kantsevoy SV, Gostout CJ (2007) Submucosal endoscopic esophageal myotomy: a novel experimental approach for the treatment of achalasia. Endoscopy 39:761–764
Donahue PE, Teresi M, Patel S, Schlesinger PK (1999) Laparoscopic myotomy in achalasia: intraoperative evidence for myotomy of the gastric cardia. Dis Esophagus 12:30–36
Oelschlager BK, Chang L, Pellegrini CA (2003) Improved outcome after extended gastric myotomy for achalasia. Arch Surg 138:490–495
Oddsdottir M (2006) Laparoscopic cardiomyotomy (Heller myotomy). In: Carol EH (ed) The SAGES manual, 2nd edn. Springer, Scott-Conner, NY, p 244
Moyer MT, Pauli EM, Haluck RS, Mathew A (2007) The self-approximating translumenal access technique (STAT) for potential use in NOTES: an ex vivo porcine model. Gastrointest Endosc 66:974–978
Pauli EM, Moyer MT, Haluck RS, Mathew A (2008) Self-approximating translumenal access technique (STAT) for NOTES: a porcine survival study (with video). Gastrointest Endosc 67:690–697
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Pauli, E.M., Mathew, A., Haluck, R.S. et al. Technique for transesophageal endoscopic cardiomyotomy (Heller myotomy): video presentation at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2008, Philadelphia, PA. Surg Endosc 22, 2279–2280 (2008). https://doi.org/10.1007/s00464-008-0035-5
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DOI: https://doi.org/10.1007/s00464-008-0035-5