The Role of POP in Medically Refractory Gastroparesis

Gastroparesis is a disorder characterized by delayed gastric emptying and is associated with significant impairment in patient quality of life. Although its pathogenesis is not fully understood, it is thought to arise from a combination of cellular, structural, and neuromuscular abnormalities involving the gastric body and pylorus. While established medical therapies target these underlying mechanisms, a subset of patients remain refractory to pharmacologic management and require procedural intervention. Per-oral pyloromyotomy (POP) has emerged as a minimally invasive therapeutic option that directly targets pyloric dysfunction. In this review, we examine the pathophysiology of gastroparesis, describe the technical aspects of the POP procedure, and summarize current clinical outcomes and safety data supporting its role in the management of medically refractory gastroparesis.