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Table of Contents
Preface; Contents; Contributors; 1: Introduction: Endoscopic Submucosal Dissection to Per Oral Endoscopic Myotomy (POEM); Introduction; Endoscopic Mucosal Resection (EMR); Strip Biopsy; Band Ligation; Evolution of the Distal Cap; Large-Volume Injection; Endoscopic Submucosal Dissection (ESD); From EMR to ESD; Evolution of Knives; Submucosal Tunneling; POEM; Experimental Endoscopic Myotomy; Early Experience with Human POEM; Summary and Future Trends; References; 2: POEM: Concept to Research Laboratory; Introduction; History of Achalasia Therapy; Pathophysiology; Early Endoscopic Myotomy.
Third Space Endoscopy Technical Maturation; Future Trends; References; 3: Current and Emerging Instruments and Energy; Introduction; Devices for POEM; Endoscopes; Overtubes; Gas Insufflation; Knives; Electrosurgical Units (ESU); Hemostatic Forceps; Adjuvant Tools for Tissue Retraction and Enhanced Visualization; Injection Agents and Devices; Biliary Extraction Balloon; Mucosal Closure Devices; Summary; References; 4: Indications and Preoperative Workup for Peroral Endoscopic Myotomy; Peroral Endoscopic Myotomy; Achalasia; Symptom Evaluation; Dysphagia; Regurgitation.
Chest Pain Heartburn; Weight Loss; Symptom Scores; Past Medical History; Diagnostic Evaluation; Upper Endoscopy; Contrast Esophagram; Esophageal Manometry; Ambulatory pH Monitoring; Expanded Indications; References; 5: Clinical Introduction of POEM for Achalasia: Technique; Introduction; Preoperative Patient Preparation; Preoperative Operating Room Preparation; Intraoperative Patient and Staff Preparation; Operative Technique; Commentary; References; 6: Technical Modifications for Motility Disorders: Dimensions of Dissection; Introduction; Preoperative Evaluation; Manometry.
High-Resolution Manometry Analysis The Chicago Classification; Achalasia; Outflow Obstruction; Esophageal Motor Dysfunctions; POEM Technique; Mapping EGD; Dissection of the Submucosal Tunnel; Myotomy and Closure; EndoFLIP; Extended Criteria; Hypertensive Motor Disorders; End-Stage Achalasia; Previous Endoscopic and Surgical Interventions; POEM in the Pediatric Population; POEM in the Obese Population; References; 7: POEM Contraindications and Pitfalls; Introduction; POEM Contraindications and Pitfalls in Patient Selection; POEM Contraindication Due to Comorbidities.
Patients in Whom POEM May Not Represent Appropriate Therapy Procedural Pitfalls; Preprocedure Preparation; Tunnel Initiation and Orientation; Initial Submucosal Injection; Initial Mucosal Incision; Initial Entry into the Submucosal Space and Tunnel Initiation; Submucosal Tunnel Dissection; Myotomy; Closure of the Submucosal Tunnel; References; 8: Learning Curve and Initial Outcomes; Introduction; Early Outcomes; Learning Curve; Measuring EGJ Distensibility During POEM; References; 9: Comparative Outcomes: POEM Versus Balloons, Botox, and Surgical Myotomy; References.
Third Space Endoscopy Technical Maturation; Future Trends; References; 3: Current and Emerging Instruments and Energy; Introduction; Devices for POEM; Endoscopes; Overtubes; Gas Insufflation; Knives; Electrosurgical Units (ESU); Hemostatic Forceps; Adjuvant Tools for Tissue Retraction and Enhanced Visualization; Injection Agents and Devices; Biliary Extraction Balloon; Mucosal Closure Devices; Summary; References; 4: Indications and Preoperative Workup for Peroral Endoscopic Myotomy; Peroral Endoscopic Myotomy; Achalasia; Symptom Evaluation; Dysphagia; Regurgitation.
Chest Pain Heartburn; Weight Loss; Symptom Scores; Past Medical History; Diagnostic Evaluation; Upper Endoscopy; Contrast Esophagram; Esophageal Manometry; Ambulatory pH Monitoring; Expanded Indications; References; 5: Clinical Introduction of POEM for Achalasia: Technique; Introduction; Preoperative Patient Preparation; Preoperative Operating Room Preparation; Intraoperative Patient and Staff Preparation; Operative Technique; Commentary; References; 6: Technical Modifications for Motility Disorders: Dimensions of Dissection; Introduction; Preoperative Evaluation; Manometry.
High-Resolution Manometry Analysis The Chicago Classification; Achalasia; Outflow Obstruction; Esophageal Motor Dysfunctions; POEM Technique; Mapping EGD; Dissection of the Submucosal Tunnel; Myotomy and Closure; EndoFLIP; Extended Criteria; Hypertensive Motor Disorders; End-Stage Achalasia; Previous Endoscopic and Surgical Interventions; POEM in the Pediatric Population; POEM in the Obese Population; References; 7: POEM Contraindications and Pitfalls; Introduction; POEM Contraindications and Pitfalls in Patient Selection; POEM Contraindication Due to Comorbidities.
Patients in Whom POEM May Not Represent Appropriate Therapy Procedural Pitfalls; Preprocedure Preparation; Tunnel Initiation and Orientation; Initial Submucosal Injection; Initial Mucosal Incision; Initial Entry into the Submucosal Space and Tunnel Initiation; Submucosal Tunnel Dissection; Myotomy; Closure of the Submucosal Tunnel; References; 8: Learning Curve and Initial Outcomes; Introduction; Early Outcomes; Learning Curve; Measuring EGJ Distensibility During POEM; References; 9: Comparative Outcomes: POEM Versus Balloons, Botox, and Surgical Myotomy; References.