Clin Endosc.  2018 Jan;51(1):28-32. 10.5946/ce.2018.001.

Gastric Peroral Endoscopic Myotomy

• Chung H
• Khashab MA

• KMID: 2403629
• DOI: http://doi.org/10.5946/ce.2018.001

Abstract

Gastroparesis (GP) is a syndrome characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach or proximal small bowel. Currently available dietary and medical therapies are limited and have suboptimal efficacy. Pylorus-directed therapies have showed promising results. Gastric peroral endoscopic myotomy (G-POEM) has been reported for the treatment of GP refractory to standard therapy with promising results. This article reviews the current applications and results of G-POEM for the treatment of refractory GP.

Keyword

Gastric emptying; Gastroparesis; Pyloromyotomy

MeSH Terms

Gastric Emptying
Gastroparesis
Stomach

Figure

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  Fig. 1. Gastric peroral endoscopic myotomy performed in a patient with idiopathic gastroparesis. (A) Submucosal bleb is created 5 cm proximal to the pylorus at the 5 o’clock position along the greater curve. (B) Submucosal tunnel is created until the pyloric ring (C) is reached. (D) Pyloromyotomy is performed using an insulated-tip knife to avoid injury to the adjacent duodenal wall. (E, F) Closure of the mucosal entry site is accomplished using through-the-scope clips.

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