Modified peroral endoscopic myotomy: a “Push and Pull” technique
Peroral endoscopic myotomy (POEM) is a minimally invasive yet challenging procedure for achalasia. Additional technological innovations and improvements are important for simplifying the procedure.
We report the successful use of a modified POEM procedure, which utilized a “Push and Pull” technique, on a patient with achalasia.
Our modifications resulted in a short operation time of only 35 min. No complications arose during or after the procedure, up to a follow-up period of 6 months, and symptoms were significantly and quickly improved.
This modified procedure shortens operation time and lowers the difficulty of the operation, while leaving the safety and efficacy uncompromised.
KeywordsPOEM Modified procedure Push and Pull technique
Drs. Dan-Feng Zhang, Wei-Feng Chen, Quan-Lin Li, Mei-Dong Xu, Yun-Shi Zhong, Yi-Qun Zhang, and Ping-Hong Zhou have received grants from the Major Project of Shanghai Municipal Science and Technology Committee (16411950400, 14441901500, and 15JC1490300), National Natural Science Foundation of China (81470811 and 81670483), and the Project of Shanghai Municipal Commission of Health and Family Planning (201440393).
Compliance with ethical standards
Dan-Feng Zhang, Wei-Feng Chen, Mei-Dong Xu, Yun-Shi Zhong, Yi-Qun Zhang, Quan-Lin Li, Ping-Hong Zhou have no other conflicts of interest or financial ties to disclose.
Video 1: Modified peroral endoscopic myotomy using the “Push and Pull” technique (WMV 31981 KB)