Peroral endoscopic myotomy and fundoplication: a novel NOTES procedure

Haruhiro Inoue; Akiko Ueno; Yuto Shimamura; Anastassios Manolakis; Ashish Sharma; Shin Kono; Masayuki Nishimoto; Kazuya Sumi; Haruo Ikeda; Kenichi Goda; Manabu Onimaru; Noriko Yamaguchi; Hiroaki Itoh

doi:10.1055/a-0820-2731

Endoscopy, Inhaltsverzeichnis

Endoscopy 2019; 51(02): 161-164
DOI: 10.1055/a-0820-2731

Innovations and brief communications

Peroral endoscopic myotomy and fundoplication: a novel NOTES procedure

Haruhiro Inoue

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Akiko Ueno

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Yuto Shimamura

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Anastassios Manolakis

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Ashish Sharma

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Shin Kono

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Masayuki Nishimoto

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Kazuya Sumi

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Haruo Ikeda

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Kenichi Goda

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Manabu Onimaru

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Noriko Yamaguchi

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

,

Hiroaki Itoh

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University, Tokyo, Japan

› Institutsangaben

Abstract

Background Peroral endoscopic myotomy (POEM) has become the minimally invasive endoscopic treatment for achalasia; however, gastroesophageal reflux (GER) post-POEM has been reported. A pilot study was conducted in which an endoscopic fundoplication was added to the standard POEM (POEM + F) procedure to overcome this issue. We report the technical details of POEM + F and short-term safety results.

Methods POEM + F was performed in 21 patients. After completing myotomy, the endoscope was advanced from the submucosal tunnel into the peritoneal cavity. A partial mechanical barrier was created by retracting the anterior gastric wall at the esophagogastric junction with the use of endoclips and an endoloop.

Results POEM + F was technically feasible in all cases and created a visually recognizable fundoplication. The clinical course after POEM + F was uneventful. No immediate or delayed complications occurred.

Conclusion POEM + F may help mitigate the post-POEM incidence of GER and serve as a minimally invasive endoscopic alternative to a laparoscopic Heller-Dor procedure. This is the largest case series of peroral natural orifice transluminal endoscopic surgery without laparoscopic assistance in the human foregut.

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Referenzen

References
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