Obesity Surgery

, Volume 29, Issue 11, pp 3523–3526 | Cite as

Peroral Endoscopic Myotomy Is Feasible and Safe in a Gastric Bypass Population

  • Umair Bashir
  • Rami El Abiad
  • Henning Gerke
  • John Keech
  • Kalpaj Parekh
  • Peter Nau
Original Contributions



Obesity is public health problem of epidemic proportions. Esophageal dysmotility including achalasia is more commonly seen in an obese population. Standard therapy for achalasia can be complicated by hepatomegaly and a post-surgical anatomy in a pre- and post-bariatric population. Peroral endoscopic myotomy (POEM) has not been adequately studied in this population.


A retrospective review of a prospectively collected database was completed. Patients who had undergone a Roux-en-y gastric bypass (RYGB) prior to or following a POEM were enrolled. Patient demographics, operative information and post-operative course data was collected.


Six patients underwent POEM prior to or after RYGB. There were no peri-operative complications with an average length of stay of 1.2 days. Five patients experienced a clinical success with excellent symptom resolution. The one failure was in the setting of type III achalasia, but did have objective evidence of lower esophageal sphincter (LES) relaxation post-operatively.


POEM in the setting of bariatric surgery is safe and feasible. The potential increase in GERD following POEM is obviated by RYGB anatomy. In an obese individual, a staged POEM prior to or following a RYGB is an appropriate treatment algorithm for obese and achalasia.


POEM Bariatric surgery Achalasia 


Compliance with Ethical Standards

The study obtained approval from the Institutional Research Board including a waiver of informed consent due to the retrospective nature of the study (IRB # 201611724).

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Iowa CityUSA

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