Peroral endoscopic myotomy for esophageal achalasia: Indication and technique

Since the inception of peroral endoscopic myotomy (POEM) in 2008, more than 2000 POEMs have been performed to date in the world. The technique has been standardized to include the following 5 steps: mucosectomy, submucosal tunnel creation, esophageal myotomy, cardiomyotomy, and mucosectomy closure. Minor technique variations do exist as far as the equipment utilized as well as with the orientation and completeness of the myotomy. This article describes the equipment used during POEM as well as the essential steps to have a safe and successful procedure.