Per-oral endoscopic myotomy: emerging indications and evolving techniques

Area of Science:

• Gastroenterology and Endoscopy
• Surgical Innovation
• Esophageal Motility Disorders

Background:

• Esophageal achalasia is a motility disorder characterized by impaired lower esophageal sphincter relaxation.
• Traditional treatments include balloon dilatation, botulinum toxin injection, and surgical myotomy.
• Per-oral endoscopic myotomy (POEM) emerged as a novel endoscopic approach in 2008.

Purpose of the Study:

• To review the historical development of POEM for achalasia.
• To discuss the current status and applications of POEM.
• To explore future prospects and technical advancements in POEM.

Main Methods:

• Review of historical data and published literature on POEM.
• Analysis of POEM's technical evolution and clinical outcomes.
• Discussion of expanded indications and emerging techniques.

Main Results:

• POEM offers a minimally invasive alternative to traditional achalasia treatments.
• The procedure demonstrates high efficacy and wide acceptance.
• Ongoing developments are expanding POEM's utility and indications.

Conclusions:

• POEM has become a significant treatment modality for esophageal achalasia.
• Its minimally invasive nature and effectiveness support its widespread adoption.
• Future research will likely focus on further refining techniques and broadening applications.