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Related Experiment Video

Updated: May 12, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia

Robotic Myotomy and Partial Fundoplication for Achalasia

Published on: August 11, 2023

Suture-based fundoplication techniques during peroral endoscopic myotomy.

Farimah Fayyaz¹, Michael Bejjani¹, Romina Roshanshad¹

¹Gastroenterology and Hepatology Division, Johns Hopkins Medicine, Baltimore, Maryland, USA.

Videogie : an Official Video Journal of the American Society for Gastrointestinal Endoscopy

|May 11, 2026

Summary

Novel suture-based techniques for peroral endoscopic myotomy with fundoplication (POEM-F) show promise for managing achalasia, offering improved procedural control over traditional methods.

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Last Updated: May 12, 2026

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Area of Science:

Gastroenterology
Endoscopic Surgery

Background:

Peroral endoscopic myotomy with fundoplication (POEM-F) aims to prevent reflux after achalasia treatment.
Conventional loop-ligating devices for POEM-F present technical challenges and durability concerns.

Purpose of the Study:

To describe two novel suture-based techniques for endoscopic fundoplication following POEM.
To evaluate the feasibility and initial outcomes of these new suture techniques.

Main Methods:

Two patients with type II achalasia underwent POEM-F using distinct suture-based approaches.
Technique 1: Over-the-scope suturing system for seromuscular sutures and cinch.
Technique 2: T-Tag suture retrieval and anchoring with helical tacks.

Main Results:

Both suture-based fundoplication techniques were successfully applied in patients with type II achalasia.
No adverse events were reported during or after the procedures.
The described methods offer alternative approaches to conventional loop-ligating devices.

Conclusions:

Suture-based techniques for POEM-F represent a promising alternative to existing methods.
These novel approaches may enhance procedural control and warrant further investigation for long-term durability.
Further development of dedicated endoscopic suturing systems could optimize these techniques for POEM-F.