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POEM, the Prototypical "New NOTES" Procedure and First Successful NOTES Procedure
Robert Bechara1, Haruhiro Inoue2
1Digestive Diseases Centre, Showa University Koto-Toyosu Hospital, Toyosu 5-1-38, Koto-Ku, Tokyo 135-8577, Japan; Queen's University Division of Gastroenterology Kingston General and Hotel Dieu Hospitals, 166 Brock Street, Kingston, Ontario K7L 5G2, Canada.
Abstract:
Peroral endoscopic myotomy (POEM) was first performed in 2008 as a novel treatment of achalasia. It is now performed globally, demonstrating the evolution of the first successful natural orifice transluminal endoscopic surgery (NOTES) procedure. There is extensive data demonstrating the safety and efficacy of POEM, and now long-term data has emerged demonstrating that the efficacy is durable. POEM is also being used to successfully treat diffuse esophageal spasm (DES) and jackhammer esophagus. With jackhammer esophagus and DES, inclusion of the lower esophageal sphincter in the myotomy minimizes the risk of symptom development from iatrogenic ineffective esophageal motility.
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