Peroral endoscopic myotomy (POEM) is the application of esophageal myotomy to the concept of natural orifice transluminal surgery (NOTES) by utilizing a submucosal tunneling method. Since the first case of POEM was performed for treating achalasia in Japan in 2008, this procedure is being more widely used by many skillful endosopists all over the world. Currently, POEM is a spotlighted, emergin...

Aim : The aim of this study was to investigate whether intraoperative endoscopy (IOE) helps to identify the gastroesophageal junction, thereby reducing the frequency of suboptimal distal myotomy extent during laparoscopic Heller’s cardiomyotomy. To this end, laparoscopic and endoscopic criteria for localization of the cardia were compared. Then surgical outcomes in two consecutive groups of pat...

HYPOTHESIS Laparoscopic Heller myotomy with anterior fundoplication will alleviate the symptoms of achalasia and result in excellent patient satisfaction. DESIGN Retrospective study of consecutive patients who underwent laparoscopic Heller myotomy with anterior fundoplication for achalasia between October 1995 and July 1999. A telephone survey assessed symptoms and satisfaction. Patients were...

BACKGROUND/AIMS The motility change after peroral endoscopic myotomy (POEM) in achalasia is currently focused on lower esophageal sphincter (LES). This study aims to investigate the correlation of motility response between distal and proximal esophagus after POEM. METHODS A total of 32 achalasia patients who received POEM and high-resolution manometry (HRM) were included for analysis. Eckardt...

Obstetrical trauma to external anal sphincter (EAS) is extremely common; however, its role in the development of anal incontinence is not clear. We examined the regenerative process and functional impact of experimental surgical trauma to EAS muscle in an animal model. Surgical myotomy, a craniocaudal incision extending along the entire length and thickness of the EAS, was performed in rabbits....

Aim The aim of this study was to evaluate and compare the functional results before and after laparoscopic Heller myotomy for Iranian patients with achalasia. Background Achalasia is a severe neuromuscular disorder of the esophagus, characterized by the loss of peristalsis and an inability of the lower esophageal sphincter (LES) to reach optimal relaxation. Methods In this cross sectional s...

myotomy during peroral endoscopic myotomy Peroral endoscopic myotomy (POEM) is being increasingly performed for the management of achalasia. One of the major technical challenges in performing POEM is assessing the extent of the submucosal tunnel, as this will determine the extent of the myotomy. The myotomy should extend 2–3cm beyond the lower esophageal sphincter, as an adequate cardiomyotomy...

Zenker s diverticulum arises in the posterior wall of the pharynx, above the cricopharyngeal muscle, secondary to a functional cricopharyngeal disorder. We describe our experience with the management of Zenker s diverticulum from 1985 to this day in a third-level hospital. We review clinical data from 27 patients (78% males) with a mean age of 60.4 years. The most common clinical manifestations...

BACKGROUND Prospective studies comparing laparoscopic to open Heller myotomy for esophageal achalasia are lacking. The aim of this study was to compare functional outcome after laparoscopic and open Heller myotomy for esophageal achalasia. METHODS Eighty-two patients who underwent Heller-Dor myotomy for achalasia, via laparoscopy (n=52) or open surgery (n=30) were recorded prospectively (1993...