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Journal of Gastrointestinal Surgery

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01-11-2017 | Multimedia Article

How I Do It: Per-Oral Pyloromyotomy (POP)

Authors: Matthew T. Allemang, Andrew T. Strong, Ivy N. Haskins, John Rodriguez, Jeffrey L. Ponsky, Matthew Kroh

Published in: Journal of Gastrointestinal Surgery | Issue 11/2017

Abstract

Introduction

Several surgical treatments exist for treatment of gastroparesis, including gastric electrical stimulation, pyloroplasty, and gastrectomy. Division of the pylorus by means of endoscopy, Per-Oral Pyloromyotomy (POP), is a newer, endoluminal therapy that may offer a less invasive, interventional treatment option.

Methods

We describe and present a video of our step by step technique for POP using a lesser curvature approach. The following are technical steps to complete the POP procedure from the lesser curve approach.

Conclusion

In our experience, these methods provide promising initial results with low operative risks, although long-term outcomes remain to be determined.

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Bharucha AE. Epidemiology and natural history of gastroparesis. Gastroenterol Clin North Am [Internet]. 2015;44(1):9–19. Available from: http://dx.doi.org/10.1016/j.gtc.2014.11.002 CrossRef

Choung RS, Locke GR, Schleck CD, Zinsmeister AR, Melton LJ, Talley NJ. Risk of Gastroparesis in Subjects With Type 1 and 2 Diabetes in the General Population. Am J Gastroenterol [Internet]. 2012; 107(1):82–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22085818 CrossRef

McCarty TR, Rustagi T. Endoscopic treatment of gastroparesis. World J Gastroenterol. 2015;21(22):6842–9.CrossRefPubMedPubMedCentral

Toro JP, Lytle NW, Patel AD, Davis SS, Christie JA, Waring JP, et al. Efficacy of laparoscopic pyloroplasty for the treatment of gastroparesis. J Am Coll Surg [Internet]. 2014;218(4):652–60. Available from: http://dx.doi.org/10.1016/j.jamcollsurg.2013.12.024 CrossRef

Clarke JO, Snape WJ. Pyloric sphincter therapy: Botulinum toxin, stents, and pyloromyotomy. Gastroenterol Clin North Am [Internet] 2015;44(1):127–36. Available from: http://dx.doi.org/10.1016/j.gtc.2014.11.010 CrossRef

Sarosiek I, Davis B, Eichler E, McCallum RW. Surgical approaches to treatment of gastroparesis: Gastric electrical stimulation, pyloroplasty, total gastrectomy and enteral feeding tubes. Gastroenterol Clin North Am [Internet]. 2015;44(1):151–67. Available from: http://dx.doi.org/10.1016/j.gtc.2014.11.012 CrossRef

Khashab MA, Stein E, Clarke JO, Saxena P, Kumbhari V, Chander Roland B, et al. Gastric peroral endoscopic myotomy for refractory gastroparesis: First human endoscopic pyloromyotomy (with video). Gastrointest Endosc. 2013;78(5):764–8.CrossRefPubMed

Ponsky JL, Marks JM, Pauli EM. How I Do It: Per-Oral Endoscopic Myotomy (POEM). J Gastrointest Surg. 2012;16(6):1251–5.CrossRefPubMed

Gonzalez JM, Lestelle V, Benezech A, Cohen J, Vitton V, Grimaud JC, et al. Gastric per-oral endoscopic myotomy with antropyloromyotomy in the treatment of refractory gastroparesis: Clinical experience with follow-up and scintigraphic evaluation (with video). Gastrointest Endosc [Internet]. 2016;85(1):132–9. Available from: http://dx.doi.org/10.1016/j.gie.2016.07.050 CrossRef

10.

Khashab MA, Ngamruengphong S, Carr-Locke D, Bapaye A, Benias PC, Serouya S, et al. Gastric per-oral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video). Gastrointest Endosc [Internet]. 2016;1–6. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0016510716303327

11.

Mekaroonkamol P, Li LY, Dacha S, Xu Y, Keilin SD, Willingham FF, et al. Gastric peroral endoscopic pyloromyotomy (G-POEM) as a salvage therapy for refractory gastroparesis: a case series of different subtypes. Neurogastroenterol Motil. 2016;28(8):1272–7.CrossRefPubMed

12.

Camilleri M, Parkman HP, Shafi M A, Abell TL, Gerson L. Clinical guideline: Management of gastroparesis. Am J Gastroenterol [Internet]. 2013;108(1):18–37. Available from: http://www.scopus.com/inward/record.url?eid=2-s2.0-84872013597&partnerID=40&md5=a4ed8e764e92ca3f6f244a4c7e776657 CrossRefPubMed

13.

Fukami N, Anderson MA, Khan K, Harrison ME, Appalaneni V, Ben-Menachem T, et al. The role of endoscopy in gastroduodenal obstruction and gastroparesis. Gastrointest Endosc. 2011;74(1):13–21.CrossRefPubMed

14.

Lo SK, Fujii-Lau LL, Enestvedt BK, Hwang JH, Konda V, Manfredi MA, et al. The use of carbon dioxide in gastrointestinal endoscopy. Gastrointest Endosc [Internet]. 2016;83(5):857–65. Available from: http://dx.doi.org/10.1016/j.gie.2016.01.046 CrossRef

15.

Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: An advisory statement from the National Surgical Infection Prevention Project. Am J Surg. 2005;189(4):395–404.CrossRefPubMed

16.

Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, et al. Gastroparesis Cardinal Symptom Index (GCSI): Development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004;13(4):833–44.CrossRefPubMed

Title: How I Do It: Per-Oral Pyloromyotomy (POP)
Authors: Matthew T. Allemang
Andrew T. Strong
Ivy N. Haskins
John Rodriguez
Jeffrey L. Ponsky
Matthew Kroh
Publication date: 01-11-2017
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 11/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-017-3510-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How I Do It: Per-Oral Pyloromyotomy (POP)

Abstract

Introduction

Methods

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Conclusion

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