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Updated: Aug 10, 2026

Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
Published on: March 3, 2023
Capnoperitoneum During Peroral Endoscopic Myotomy-Recognition and Management: A Case Report
Eric Lee1, Jay B Brodsky, Homero Rivas
1From the Departments of *Anesthesiology, Perioperative and Pain Medicine, and †Surgery, Division of Minimally Invasive Surgery, Stanford University School of Medicine, Stanford, California.
Abstract:
Peroral endoscopic myotomy (POEM) is a minimally invasive procedure for treating esophageal achalasia. During POEM, carbon dioxide is insufflated under pressure into the esophagus and stomach, which can cause clinically significant capnoperitoneum, capnomediastinum, or capnothorax. We present a case in which gas accumulation in the abdomen during POEM had adverse effects on ventilation. Once the cause was recognized, needle decompression of the abdomen led to immediate improvement in ventilation.
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