Faculty Collaboration Database

Per-Oral Endoscopic Myotomy (POEM) After Previous Laparoscopic Heller Myotomy Is Feasible and Safe in a Porcine Model. Surg Laparosc Endosc Percutan Tech 2015 Oct;25(5):408-11

Date

10/03/2015

Pubmed ID

26429051

DOI

10.1097/SLE.0000000000000200

Scopus ID

2-s2.0-84943175889 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

PURPOSE: We sought to evaluate the feasibility, safety, and difficulty of performing the per-oral endoscopic myotomy (POEM) procedure in the setting of a prior Heller myotomy using a survival porcine model.

METHODS: Four pigs underwent laparoscopic Heller myotomy with Dor partial anterior fundoplication followed by the POEM performed 4 weeks later. Two additional pigs served as controls, undergoing only the POEM.

RESULTS: All procedures were completed without complications. The revisional POEM was not significantly more difficult than POEM controls based on procedure time, POEM procedure components, or procedure difficulty scores. Revisional POEM had a longer mean operative time when compared with Heller myotomy (126.0 vs. 83.8 min; P<0.01) but had a lower total difficulty score (28.6 vs. 52.1; P≪0.01).

CONCLUSIONS: A POEM after previous Heller myotomy is safe and feasible in the porcine model and has potential as an option for patients suffering from recurrent or persistent symptoms after failed surgical myotomy.

Author List

Miles LF, Frelich MJ, Gould JC, Dua KS, Jensen ES, Kastenmeier AS

Authors

Kulwinder S. Dua MD Professor in the Medicine department at Medical College of Wisconsin
Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Eric S. Jensen DVM Associate Professor in the Research Office department at Medical College of Wisconsin
Andrew Sean Kastenmeier MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Animals
Disease Models, Animal
Esophageal Achalasia
Esophageal Sphincter, Lower
Feasibility Studies
Female
Fundoplication
Laparoscopy
Mouth
Natural Orifice Endoscopic Surgery
Prospective Studies
Reoperation
Swine