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Related Experiment Video

Updated: Nov 29, 2025

Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
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Implementation of a peroral endoscopic myotomy program.

Pablo Miranda-García1, Raquel Muñoz González1, José Carlos Marín Gabriel2

  • 1Gastroenterology, Hospital Universitario de La Princesa, España.

Revista Espanola De Enfermedades Digestivas
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Summary

Developing a peroral endoscopic myotomy (POEM) program is feasible and safe. Training on animal models and expert supervision during initial human cases significantly reduced adverse events, ensuring effective patient outcomes.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Endoscopic Procedures

Background:

  • Establishing a Peroral Endoscopic Myotomy (POEM) program requires specialized training.
  • A two-step approach involving animal models and expert supervision is proposed for safe POEM implementation.

Purpose of the Study:

  • To develop a safe and effective Peroral Endoscopic Myotomy (POEM) program.
  • To evaluate the impact of animal model training and expert supervision on POEM outcomes.

Main Methods:

  • A single endoscopist underwent POEM training, starting with swine models (preclinical phase) and progressing to human cases (clinical phase) under supervision.
  • Technical aspects and adverse events were prospectively recorded in both phases.
  • Preclinical cases were divided into two groups (A and B) to assess learning curve progression.

Main Results:

  • In the preclinical phase, 15 POEM procedures on pigs showed a reduction in severe adverse events from 57% in group A to 12% in group B.
  • The clinical phase included 11 POEM procedures in patients, achieving 100% technical success and 91% clinical success (Eckardt score ≤ 3).
  • One mild pneumoperitoneum was the only adverse event, with no severe complications reported.

Conclusions:

  • Training on animal models and supervised initial human cases enables safe and effective Peroral Endoscopic Myotomy (POEM) performance.
  • This structured training approach facilitates skill acquisition and minimizes risks in developing a new endoscopic procedure.