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World J Gastrointest Endosc. May 16, 2015; 7(5): 496-509
Published online May 16, 2015. doi: 10.4253/wjge.v7.i5.496
Peroral endoscopic myotomy
Vivek Kumbhari, Mouen A Khashab
Vivek Kumbhari, Mouen A Khashab, Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, MD 21205, United States
Author contributions: All authors were involved in writing and critical revision of the manuscript.
Conflict-of-interest: Mouen A Khashab is a consultant for Boston Scientific and Olympus America and has received research support from Cook Medical; Vivek Kumbhari has no relevant disclosures.
Correspondence to: Mouen A Khashab, MD, Associate Professor, Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, 1800 Orleans St, Suite 7125 B, Baltimore, MD 21205, United States. mkhasha1@jhmi.edu
Telephone: +1-443-2871960 Fax: +1-410-5020198
Received: October 6, 2014
Peer-review started: October 6, 2014
First decision: October 28, 2014
Revised: November 15, 2014
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: May 16, 2015
Processing time: 223 Days and 21.9 Hours
Core Tip

Core tip: Peroral endoscopic myotomy (POEM) is a minimally invasive, scarless approach to Heller myotomy for the palliation of symptoms of achalasia and spastic esophageal disorders. Current data demonstrates short-term success with minimal adverse events. POEM is no longer considered experimental with approximately 5000 procedures performed worldwide. In the future, a personalized approach to POEM will be undertaken with tailoring of the length of gastric myotomy based on intraprocedural physiological measurements. This will allow sufficient reduction in pressure at the lower esophageal sphincter for adequate relief of symptoms but also minimize gastroesophageal reflux.