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Peroral Endoscopic Myotomy (POEM) at UPMC

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POEM is an incisionless procedure to treat achalasia and other swallowing disorders.

For people with achalasia, the muscles in the esophagus don't work properly. POEM may help you avoid further surgery for swallowing problems.

Benefits of Peroral Endoscopic Myotomy for Achalasia

The main benefit of this relatively new surgical procedure is that there are no cuts on your body.

The surgeon uses an endoscope — a flexible tube inserted through the mouth. The scope allows the doctor to see inside the esophagus and stomach.

This process means you spend less time in the hospital and may recover faster than with current minimally invasive achalasia surgery. In addition, POEM may offer improved outcomes over traditional surgery with fewer risks.

Pioneered in Japan, surgeons in the United States have only been performing POEM for a few years.

POEM requires significant expertise — just a small number of surgeons in the U.S. perform the surgery — so it's crucial to find a medical center with this expertise.

Surgeons at the UPMC Esophageal and Lung Surgery Institute were quick to adopt this new technique.

We have the skill and experience to provide you with the best possible outcomes.

Preparing for Peroral Endoscopic Myotomy Surgery

Your care team at the UPMC Esophageal and Lung Surgery Institute will give you instructions about how to prepare for your POEM surgery.

We'll let you know what drugs to stop taking and give you a detailed diet plan.

  • Three days before surgery, you'll start a full liquid diet. This means foods like cream soups, smoothies, and pudding.
  • The day before POEM surgery, you'll change to a clear liquid diet.
  • The night before surgery, you'll need to do a gentle bowel prep.

Don't hesitate to contact us any time with questions about your peroral endoscopic myotomy.

During Peroral Endoscopic Myotomy Surgery

You will receive general anesthesia, so you'll sleep through the entire POEM operation.

Your surgeon will:

  • Insert the endoscope in your mouth and down into your esophagus. The scope carries a camera and a special surgical knife.
  • Use the knife to cut the muscles causing your swallowing problems.

After Peroral Endoscopic Myotomy Surgery

You'll spend at least one night in the hospital. You can go home in 24 to 48 hours if everything is normal.

While in the hospital:

  • We will monitor your pain and perform a swallowing study to make sure your esophagus is passing — or will be able to pass — food properly.
  • You'll follow a liquid diet.
  • A dietitian will work with you to slowly advance your diet back to solid foods. He or she will tailor an eating plan to your specific health and healing progress.

Once your go home, we'll watch you closely for complications through follow-up visits.

The goal of any surgery at UPMC is to help you return to a normal lifestyle.

Our care team is here to answer any questions you have during your recovery. Contact us at the UPMC Esophageal and Lung Surgery Institute any time.