The per-oral endoscopic myotomy, or POEM, is a minimally invasive surgical procedure for the treatment of achalasia wherein the inner circular muscle layer of the lower esophageal sphincter is divided through a submucosal tunnel.
[1] The principles of an endoscopic surgical myotomy were developed in the 2000s on animal models by Pankaj "Jay" Pasricha at University of Texas Medical Branch.
Patients usually spend 1–3 days in the hospital before going home, and usually undergo a swallow study prior to resuming oral feeding.
[9] Escape of air introduced through the endoscope into the surrounding tissues is a common occurrence and rarely requires additional intervention.
[9] This phenomenon is usually mild and manageable with medication alone, and does not occur at a significantly higher rate than in patients undergoing a traditional surgical therapy.
POEM has been established as a safe and efficacious treatment for achalasia and is becoming increasingly popular as a first line alternative to conventional laparoscopic myotomy.