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Updated: Jun 14, 2025

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Complications related to third space endoscopic procedures.

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Third space endoscopy (TSE), particularly per-oral endoscopic myotomy (POEM), can lead to complications like bleeding and infections. This review identifies risks and suggests interventions for managing adverse events in POEM procedures.

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Adverse eventsBleedingComplicationsGas related injuryGastroesophageal reflux disease (GERD)LeakPer-Oral Endoscopic MyotomyThird space endoscopy

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Area of Science:

  • Gastroenterology and Endoscopy
  • Minimally Invasive Surgery

Background:

  • Third space endoscopy (TSE) offers diverse treatments for gastrointestinal (GI) disorders.
  • Per-oral endoscopic myotomy (POEM) is a prominent TSE procedure with expanding applications.

Purpose of the Study:

  • To review potential complications associated with POEM.
  • To identify risk factors contributing to adverse events.
  • To recommend salvage interventions for POEM-related complications.

Main Methods:

  • Literature review of adverse events in third space endoscopy.
  • Analysis of common complications in per-oral endoscopic myotomy.
  • Evidence-based recommendations for complication management.

Main Results:

  • Common POEM complications include insufflation injuries, bleeding, mucosal barrier defects, infections, pain, myotomy defects, and GERD.
  • Risk factors for these adverse events are identified.
  • Effective salvage interventions are discussed.

Conclusions:

  • Understanding POEM pitfalls is crucial for patient safety.
  • Proactive risk identification and management can minimize adverse events.
  • Appropriate salvage strategies improve outcomes in TSE procedures.