Submucosal endoscopy: from ESD to POEM and beyond.

Area of Science:

• Gastroenterology and Endoscopy
• Minimally Invasive Surgery

Background:

• Esophageal achalasia symptoms necessitate effective long-term treatment.
• Traditional surgical myotomy has limitations.
• Endoscopic submucosal dissection techniques offer new possibilities.

Purpose of the Study:

• To describe the development and evolution of Peroral Endoscopic Myotomy (POEM).
• To report and discuss the practical application of POEM.
• To introduce submucosal endoscopic tumor resection as an extension of POEM.

Main Methods:

• POEM combines principles of surgical esophageal myotomy.
• POEM utilizes advanced endoscopic submucosal dissection techniques.
• Clinical use and outcomes of POEM are reviewed.

Main Results:

• POEM provides a minimally invasive, scarless surgical option.
• The procedure is effective for managing esophageal achalasia symptoms.
• Submucosal endoscopic tumor resection is presented as a novel application.

Conclusions:

• POEM represents a significant advancement in endoscopic surgery for achalasia.
• The technique offers a promising alternative to traditional surgery.
• Further applications, such as tumor resection, are being explored.