Another case of POEM performed in our hospital. This is a type I achalasia in an 86-year-old man. A standard myotomy (10 cm in length) was performed. An Olympus Triangle tip-J type knife and the ERBE Precise sect mode were used. This configuration allows dissection and coagulation in a more efficient way in ESD and POEM techniques.
Excellent review on the physical principles of precise sect technology and its application in ESD and POEM by Dr. Torsten Beyna and Dr. Roberta Maselli. The precise sect mode regulates itself according to the impedance of the tissue, which in turn is related to the contact surface of the knive with it. Thus, for the precoagulation of medium-sized vessels (0.5-1.5 mm), it is necessary to expose a wide contact surface of the knive on the sides of the vessel (once it has been properly dissected) and press the coagulation pedal during 1-2 seconds. When the vessels are smaller and are not arterial, they can be coagulated with a wide contact surface of the scalpel, without pressing it and pressing the blue pedal for 1-2 seconds. link to website
Precoagulation of medium sized blood vessels (0.5-1 mm) can be achieved with the Precise sect mode through lower impedance. It is achieved by applying larger contact surfaces without pressing the vessel with continuous activation of the coagulation pedal for 1-2 seconds. This may allow ESD and POEM to be performed more safely, without bleeding and therefore more quickly. Link to website
The case of a type II achalasia treated with the POEM technique in a 41-year-old male patient is presented. The entire case is fully exposed without editing.
Performance of POEM in a patient with Jackhammer esophagus by Doctors Albéniz and Gallego during the course «Third space and mucosal resection in digestive endoscopy» on May 6th and 7th, 2021 in the digestive unit of the Poniente hospital ( El Ejido. Almería)
Performance of STER technique in a patient with a gastric GIST by Doctors Rosón and Guilarte during the course «Third space and mucosal resection in digestive endoscopy» on May 6th and 7th, 2021 in the digestive unit of the Poniente hospital ( El Ejido. Almería)