PER ORAL ENDOSCOPIC MYOTOMY

Per Oral Endoscopic Myotomy

It is an endoscopic procedure used to treat swallowing disorders, most commonly for Achalasia. This is an in-patient procedure and can take between one to three hours to complete.

Achalasia and other swallowing disorders are usually caused by the esophagus muscles dysfunction and failure of lower esophagus sphincter muscles to relax, making it hard to swallow and hard for the food to pass into the stomach. Other symptoms besides swallowing issues may be retrosternal pain while swallowing food, weight loss, regurgitation of undigested food, recurrent cough and an overall low quality of life.

A benefit of having an endoscopic procedure, especially for swallowing disorders, is that there are no incisions in the chest or abdomen and includes a minimal or sometimes no hospital stay post-procedure. Currently there are only a handful of centers in the India offering this less-invasive approach to treating swallowing disorders and this is the only center in Saurashtra-Kutch region offering this procedure.

Our area of clinical expertise include:

Indications

❖ Achalasia Cardia
❖ Spastic esophageal disorders not responding to medical therapies (e.g., diffuse esophageal spam, nutcracker esophagus)

Pre-procedure preparation:

❖ Have only a liquid diet for two days prior to the procedure. ❖ Do not eat or drink for 12 hours prior to your procedure. This ensures that your esophagus is clear of food products. ❖ Do not take your anti-diabetic medicines on the day of the procedure. ❖ Stop certain blood thinning agents a few days prior to procedure.

Procedure

❖ The procedure is done under general anaesthesia. ❖ Endoscope is passed to esophogus ❖ The superficial layer of wall of esophagus (Mucosa) is cut with special knife. ❖ A tunnel is made in the wall of the esophagus by carefully injecting and cutting from above downwards ❖ This allows access to Muscle. ❖ Through the tunnel muscle layer is cut all the way through the esophagus, lower esophageal sphincter to upper part of stomach ❖ It relieves the tightness of the lower esophageal sphincter. ❖ The mucosal defect is closed with clips.

Complications:

❖ Esophageal Perforation, Bleeding Risk, GERD ❖ The patient is usually started on clear liquids on the next day of procedure and is discharged on the 3rd day.

DEPT OF MEDICAL GASTROENTEROLOGY

DR. K. K. RAWAL (MD, DM – GASTRO)
DR. AVVAL K. SADIKOT (MD, DNB-GASTRO)
DR. CHINTAN H. KANSAGRA (MD,DNB – GASTRO)
DR. CHINTAN M. MORI (MD,DNB – GASTRO)

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PER ORAL ENDOSCOPIC MYOTOMY