Abstract
POEM represents a groundbreaking NOTES approach to LES myotomy that boasts excellent initial outcomes rivaling short-term outcomes of laparoscopic Heller myotomy (LHM). POEM represents a paradigm shift in treatment and is currently in an exponential growth phase. In 2009 we performed the first POEM outside of Japan and first worldwide by a gastroenterologist. Early adoption of POEM allowed maturation of our technique over the past 3 years which has now allowed us to increasingly perform POEM for “extended indications” including patients with significant comorbidities, advanced achalasia, prior failed treatments including failed LHM and advanced age.
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