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Updated: Feb 3, 2026

Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
Published on: March 3, 2023
Technical Aspects of Peroral Endoscopic Pyloromyotomy
Jie Tao1, Vaishali Patel2, Parit Mekaroonkamol2
1Division of Digestive Disease, Emory University School of Medicine, 1365 Clifton RD NE, Suite B 1262, Atlanta, GA 30322, USA; Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 227 Yanta West Road, Xi'an 710061, China.
Abstract:
Gastric peroral endoscopic pyloromyotomy (G-POEM or POP) is a feasible and effective procedure for the treatment of refractory gastroparesis. G-POEM is a technically demanding endoscopic procedure. As of yet, there is no consensus on the technique. A variety of techniques have been reported in published studies. The essential technical steps of the procedure are (1) establishment of submucosal tunnel in gastric antrum, (2) identification of the pyloric muscular ring, (3) selective circular myotomy, and (4) a 2.5-cm to 3.0-cm length of myotomy. There are still some technical questions unanswered, and more studies are needed to establish standardized techniques and possible improvement of outcomes.
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