The Department of Gastroenterology at the PGIMER, Chandigarh conducted a one day workshop on Peroral endoscopic myotomy (POEM) and third space endoscopy. It is a new procedure and done for the first time in PGIMER. Dr Zaheer from Asian Institute of Gastroenterology, Hyderabad participated as an expert and conducted the workshop. The workshop was conducted with the help of the Dr Komal Gandhi from the department of anaesthesia and Prof Arunanshu Behera from the department of General surgery. Drs Vishal Sharma, Narendra Dhaka and Harshal Mandavdhare, all faculty members of the gastroenterology department, performed these procedures in the patients of Achalasia cardia.
Prof Rakesh Kochhar, head of the department of gastroenterology, informed that peroral endoscopic myotomy has emerged as an endoscopic choice for treatment of achalasia cardia with good results and has emerged as the first line therapy for this condition. He also informed that the department is already providing endoscopic dilatation and botulinum injection therapy for these patients and with addition of POEM the patients of the region will benefit. This procedure paves way for addition of various other third space endoscopic procedures and submucosal procedures in PGI. These procedures are aimed at being minimally invasive, through endoscopes and avoid major surgery. However, we need to create operation theatre like facility in the endoscopy suites, train our doctors, technicians and nursing staff and have support from our anaesthesia team.
Prof Usha Dutta informed that Achalasia cardia is a common disorder of the motility of the food pipe where the patients have difficulty in swallowing liquids and solids. The diagnosis is by measurement of esophageal pressures during manometry. PGI uses state of high resolution manometry to diagnose and characterize this condition. In this condition the pressure of the lower esophageal sphincter are increased and the treatment involves cutting some of the muscle fibers of this sphincter to partially release the excess pressure. Earlier these muscle fibers were cut using surgery but with POEM it is possible to do the same thing endoscopically without any surgical scar. The department is committed to provide the POEM therapy at affordable costs to the patients.
