Peroral Endoscopic Myotomy (POEM) in Mumbai

If you're seeking Peroral Endoscopic Myotomy (POEM) treatment in Mumbai or Navi Mumbai, Dr. Purushottam Vashistha clinic stands as a trusted destination for comprehensive care and successful outcomes.

Dr. Purushottam Vashistha's clinic offers patients with achalasia and other esophageal disorders a minimally invasive treatment known as Peroral Endoscopic Myotomy (POEM) in Mumbai, Navi Mumbai. Additionally, our hospital specializes in this procedure under the guidance of Dr. Purushottam Vashistha, he is a renowned gastroenterologist. This innovative technique allows for the precise cutting of the muscles of the lower esophageal sphincter, relieving swallowing difficulties and improving the quality of life for patients. Dr. Vashistha and his team ensure personalized care, guiding patients through every step of the procedure and post-operative care. With a commitment to excellence and patient satisfaction, the clinic is dedicated to delivering effective and safe treatments for esophageal disorders.

What is Peroral Endoscopic Myotomy (POEM)?

Peroral Endoscopic Myotomy (POEM) is a procedure that is minimally invasive and aims to treat individuals with achalasia or any other motility disorders of the esophagus that bring about swallowing problems. The procedure involves the insertion of an endoscope through the mouth and into the esophagus. This will enable a surgeon to pierce through the inner lining of your esophagus thereby exposing its muscle layer. This is done by cutting or taking out a piece of each of the muscles responsible for the difficulty in swallowing, thereby easing the passage of food and fluids into the stomach. POEM has numerous advantages over the other conventional forms of surgery in that it results in shorter recovery periods; fewer chances of complications occurring, and less scarring. Thus, it has become a treatment method of choice for the majority suffering from esophageal motility disorders.

POEM Surgery in Mumbai

Peroral endoscopic myotomy (POEM) surgery in Mumbai, Navi Mumbai is a minimally invasive procedure to treat swallowing disorders, especially achalasia. Achalasia is a condition in which the lower esophageal sphincter (LES) does not relax properly hence making it hard for food and liquid to enter the stomach.

While doing the POEM procedure, a physician generates a small cut in the mucosa of the esophagus and passes an endoscope through it thus enabling visualization of the interior of this organ for subsequent myotomy where there can be a surgical cutting of muscles around LES that would enable it to ease tension.

POEM surgery offers several advantages over traditional surgical methods for treating achalasia, such as laparoscopic Heller myotomy. It is less invasive, resulting in shorter hospital stays, quicker recovery times, and reduced risk of complications. Additionally, POEM can be performed on patients who may not be suitable candidates for traditional surgery due to factors like previous surgeries or anatomical issues.

In general, POEM surgery is an efficient and safe treatment choice for achalasia and other eating problems patients providing enhanced living standards and relief from symptoms. Nevertheless, all interventions are associated with a certain degree of danger while patients are recommended to have a conversation relating to these advantages.

Peroral Endoscopic Myotomy (POEM) Procedure

1. Preparation: Before the procedure, patients are normally told to fast for a given period to ensure that the stomach is empty. It might also be necessary to stop some drugs for a while as directed by their medical practitioner.
2. Endoscope Insertion: The doctor can see inside the digestive tract using the endoscope which has a light and a camera in it. The endoscope itself is a flexible tube that is inserted through the mouth and directed down the esophagus into the stomach.
3. Identification of Target Area: The doctor uses the camera located at the end of the endoscope to locate the specific point in the esophagus where the muscles need to be divided to relieve symptoms caused by such diseases as achalasia or some other motility disorder.
4. Myotomy: Our doctor will use special tools, which are passed through the endoscope, to create precise incisions on the inner lining of the esophagus once the target area has been identified. It is these incisions that form a tunnel inside the muscle layer of the esophagus.
5. Lengthening the Tunnel: The cut forms a canal within the entire infected muscle part. It is an important step in symptom management and the recovery of normal usage conditions for the esophagus.
6. Closure of Incisions: After the muscle-cutting operation has been successfully done, cuts in the esophagus are sutured so that there are no leaks of food and liquids into the chest cavity.

What to Expect After a Peroral Endoscopic Myotomy (POEM)?

After undergoing a Peroral Endoscopic Myotomy (POEM) in Mumbai, Navi Mumbai, patients can generally expect a specific recovery process and potential outcomes. It's important to note that individual experiences may vary, and it's crucial to follow the guidance of your healthcare provider.

Here's a general overview of what to expect after a POEM procedure:

1. Immediate Recovery
   • Hospital Stay: Patients typically stay in the hospital for a day or two after the procedure for monitoring and recovery.
   • Pain Management: Some discomfort, sore throat, and chest pain may be experienced initially, but medications will be prescribed to manage pain.
2. Diet and Nutrition
   • Nasogastric Tube: In some cases, a temporary nasogastric (NG) tube may be inserted to allow the esophagus to heal. This is usually removed after a day or two.
   • Gradual Introduction of Diet: Patients start with a liquid diet and gradually transition to soft foods before resuming a normal diet. The timeline for this progression will be guided by your healthcare team.
3. Activity and Rest
   • Limited Physical Activity: Patients are advised to avoid strenuous activities for a certain period to allow for proper healing.
   • Rest: Adequate rest is essential for recovery.
4. Follow-up Appointments
   • Postoperative Follow-ups: Regular follow-up appointments will be scheduled to monitor your progress and address any concerns.
   • Endoscopy: Follow-up endoscopy may be performed to evaluate the healing of the esophagus.
5. Potential Complications
   • Reflux Symptoms: Some patients may experience temporary reflux symptoms post-POEM, which can be managed with medications.
   • Infection or Bleeding: While rare, there may be a risk of infection or bleeding, so it's essential to be vigilant for any signs of complications and report them promptly to your healthcare provider.

Benefits and Risks of Peroral Endoscopic Myotomy (POEM)

Benefits of Peroral Endoscopic Myotomy (POEM):

1. Minimally Invasive: POEM is a less invasive alternative to traditional surgical methods. It is performed through the mouth, eliminating the need for external incisions. This can lead to reduced pain, shorter hospital stays, and faster recovery times.
2. Effective Treatment for Achalasia: POEM has shown high success rates in treating achalasia, a condition characterized by the inability of the lower esophageal sphincter to relax, leading to difficulty in swallowing. Patients often experience significant improvement in symptoms such as dysphagia (difficulty swallowing) after undergoing POEM.
3. Improved Quality of Life: Successful POEM procedures can result in improved quality of life for patients, with better ability to eat and drink without difficulty.
4. Avoidance of Traditional Surgery: POEM offers an alternative to traditional surgical procedures like Heller myotomy, which involves making incisions in the abdomen or chest. For patients who may not be suitable candidates for open surgery, POEM can be a viable option.
5. Shorter Hospital Stay: Typically, patients undergoing POEM may have a shorter hospital stay compared to traditional surgical options, contributing to a quicker return to normal activities.

Risks and Considerations of Peroral Endoscopic Myotomy (POEM):

1. Perforation: There is a risk of perforation or injury to the esophagus or surrounding structures during the procedure. This risk is typically managed promptly if detected and may require additional intervention.
2. Reflux: Some patients may experience gastroesophageal reflux disease (GERD) after POEM. This can lead to symptoms such as heartburn and regurgitation. Precautions and post-operative management are often implemented to minimize this risk.
3. Infection: As with any surgical procedure, there is a risk of infection, although it is generally low. Strict adherence to sterile techniques helps mitigate this risk.
4. Postoperative Pain: While POEM is less invasive than traditional surgery, some patients may experience postoperative pain or discomfort. Pain management strategies are implemented to address this concern.
5. Technical Expertise Required: Performing POEM requires specialized training and expertise in advanced endoscopic techniques. This means that not all medical centers may offer this procedure, limiting accessibility for some patients.