Our Procedures

Peroral Endoscopic Myotomy (POEM)

POEM is a procedure to treat problems with the muscles in the oesophagus, which is the passageway between the mouth and stomach.

Why the procedure is performed

Peroral endoscopic myotomy, or POEM for short, is a minimally invasive, endoscopic procedure used to treat achalasia, a disorder of the oesophagus that makes it difficult to swallow food and beverages. POEM is sometimes used to treat other swallowing difficulties as well.

How the procedure is performed

A POEM is performed under general anaesthetic during a gastroscopy, which means it’s incisionless and less risky than surgery. During the POEM, an endoscope (a narrow flexible tube with a camera) is inserted through the mouth and down to the oesophagus to make a small cut in the mucosa and submucosa (the membranes lining the oesophagus), making a temporary tunnel accessing the lower oesophageal sphincter. From here, incisions are made in the sphincter, as well as in the muscle in the lower oesophagus and upper stomach, so that it relaxes and allows food to pass into the stomach. The procedure itself takes just over an hour and you can go home the next day.

How to prepare for the procedure

Three days before the procedure, you'll start on a full liquid diet. This means foods like soups, smoothies, and puddings. Some patients with advanced disease may be advised they need more than 3 days of a full liquid diet. The day before the POEM, you'll change to a clear liquid diet. Because the POEM is done under general anaesthetic, you cannot take any food on the day of your procedure & must not drink any water within 2 hours of the procedure time.

The risks

Studies show that a POEM is more effective than conventional surgery and results in fewer side effects. The targeted POEM procedure allows for a quicker recovery and longer lasting improvements. Although the procedure is very safe, some risks may occur and require medical intervention.

Bleeding
Collapsed lung (pneumothorax)
Air bubble in the peritoneal cavity or between the lungs (pneumoperitoneum)
Air becoming trapped in tissues under the skin (subcutaneous emphysema)
Heart rhythm changes.

POEM is available at Franklin Hospital and is covered by most private insurers. To make an appointment and discuss with Dr Ravinder Ogra about if POEM is a suitable treatment for you, contact Franklin Specialist Suites on 09 220 4808.