Peroral endoscopic myotomy using a novel thin therapeutic scope

This is the authors' abstract. We don't add key points for this paper.

Peroral endoscopic myotomy (POEM) has been gaining in popularity as an effective minimally invasive treatment for achalasia [1]. However, submucosal fibrosis and thicker esophageal mucosa in patients with achalasia can complicate scope insertion into the submucosa. Furthermore, passing the scope through the esophago-gastric junction can be challenging when the lower esophageal sphincter (LES) is tight. A thinner therapeutic scope may be desirable for such challenging POEM-based procedures. POEM with a nasoendoscope is a potential solution for such situations and has shown short-term outcomes comparable to those of conventional POEM [2]. However, only certain types of endoknives can be passed through the smaller working channels of nasoendoscopes, and a lack of scope stiffness may make their manipulation difficult. A novel thin therapeutic endoscope (EG-840TP; Fujifilm Co., Tokyo, Japan), with a diameter of 7.9 mm, a wide (3.2-mm) working channel, a wide-ranging downward angle of 160°, and enhanced stiffness compared to a nasoendoscope may overcome these challenges ([Fig. 1]).