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Related Concept Videos

Esophageal Achalasia01:27

Esophageal Achalasia

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Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide...
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Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren...
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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Related Experiment Video

Updated: Apr 22, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
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Endoscopic myotomy for achalasia.

Christy M Dunst, Ashwin A Kurian, Lee L Swanstrom

    Advances in Surgery
    |October 9, 2014
    PubMed
    Summary

    Peroral Endoscopic Myotomy (POEM) effectively treats esophageal outflow disorders, relieving dysphagia. This minimally invasive technique offers a pain-free alternative to traditional surgery with comparable reflux rates.

    Area of Science:

    • Gastroenterology
    • Surgical Innovation
    • Esophageal Motility Disorders

    Background:

    • Functional manometric esophageal outflow obstructive disorders cause significant dysphagia.
    • Traditional treatments like Heller myotomy with fundoplication carry risks and incisional pain.

    Purpose of the Study:

    • To evaluate the efficacy and safety of Peroral Endoscopic Myotomy (POEM) for esophageal outflow obstructive disorders.
    • To compare POEM outcomes with traditional surgical approaches.

    Main Methods:

    • POEM procedure involving an endoscopic esophageal myotomy.
    • Assessment of dysphagia relief and reflux rates post-procedure.

    Main Results:

    • POEM demonstrated excellent relief of dysphagia in patients with esophageal outflow obstruction.

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  • Reflux rates following POEM were comparable to those observed after Heller myotomy with fundoplication.
  • The POEM technique allows for a true esophageal myotomy without the need for abdominal incisions, eliminating incisional pain.

    • Conclusions:

    • POEM is an effective treatment for functional manometric esophageal outflow obstructive disorders.
    • POEM offers a minimally invasive, pain-free surgical option for esophageal myotomy.
    • POEM represents a significant advancement in natural orifice surgery for esophageal conditions.