The Potential and Perspective of Peroral Endoscopic Esophageal Myotomy for XXXX .

@entity1 @entity1318 @entity384 @entity20801 @entity1208 @entity418 @entity130
UNASSIGNED: The therapeutic spectrum of this disorder consists of medical therapy, @entity384 , endoscopic Botox injection, open or laparoscopic @entity418 , and most recently transesophageal endoscopic myotomy ( @entity20801 peroral endoscopic myotomy). The most important requirement is a well-experienced team in interventional flexible endoscopy. The endoscopist as well as the assisting staff should have experience in advanced therapeutic endoscopic techniques and hemostasis to handle all necessary endoscopic instruments such as injection needles, needle knife, triangle knife, coagulation graspers, and endoscopic clip handling and closures. In addition, advanced surgical and especially laparoscopic skills and experience as well as surgical knowledge about @entity1208 must be available in case of conversion and/or consultation. Prior to this procedure, the @entity1 undergoes a detailed diagnostic work-up to confirm the diagnosis of @entity1318 . The procedures are performed in general anesthesia. The @entity1 is brought in a supine position, and the abdomen is free for inspection and palpation during the procedure. The myotomy can be performed in different locations around the esophageal circumference. In Europe, several centers with large experience in @entity1208 , laparoscopy, and especially advanced interventional endoscopy have started to introduce this @entity20801 -technique in their clinical practice. Initial success and low complication rates are quite promising and show a great future perspective for this technique. In the USA, @entity20801 is a procedure with a substantial increase in numbers performed in the past years with a low complication rate. The largest series are performed in Asia with a great clinical success. The perspective of @entity20801 may be the lesser access @entity130 . Its potential can be also realized in Redo cases, where experienced centers have initial experience with @entity20801 after @entity20801 and @entity20801 after LHMD.
