Eleanor Fung, MD, Jeffrey W Hazey, MD, Kyle A Perry, MD. The Ohio State University Wexner Medical Centre
Heller myotomy is considered the gold standard for Type III achalasia and diffuse esophageal spasm. However, Per-Oral Endoscopic Myotomy (POEM) is a well-documented endoscopic technique for the treatment of achalasia and has been described as a safe and feasible approach for patients after failed surgical myotomy in single institution studies. We are presenting a case of a patient who underwent POEM following Heller myotomy after reporting persistent symptoms of dysphagia and evidence of ongoing esophageal spasm above the level of the myotomy on barium swallow. This video documents the steps and technique to POEM in the setting of a previous failed myotomy.