S. Julie-Ann Lloyd, MD, PhD, Matthew T Allemang, MD, Kevin M El-Hayek, MD, Jeffrey L Ponsky, MD, Matthew D Kroh, MD, John H Rodriguez, MD. Section on Surgical Endoscopy, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
Introduction: Endoluminal surgery is an innovative and rapidly evolving field, gaining wider acceptance in the treatment of multiple gastrointestinal diseases and increasing application in patients for whom revision surgery would be especially challenging.
Case Presentation: A 70-year-old female with remote history of achalasia had been treated with a Heller myotomy in conjunction with a Belsey-Mark IV hiatal hernia repair, but subsequently required Ivor-Lewis esophagectomy and pyloroplasy. She presented to our clinic with medically refractory gastroparesis. Given her complex past surgical history, unusual anatomy and potential scarring of the pylorus, the patient was considered a candidate for endoscopic intervention. A per oral pyloromyotomy (POP) was carefully performed through a submucosal tunnel along the lesser curvature of the stomach. Post-operatively, the patient had an unremarkable overnight hospital stay and upper gastrointestinal tract study on the next day. Her symptoms had improved at three-month follow-up.
Conclusion: Endoscopic POP offers a safe and effective yet less invasive surgical treatment option for gastroparesis, particularly in patients with prior foregut surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88222
Program Number: V081
Presentation Session: Thursday Exhibit Hall Theater (Non CME)
Presentation Type: EHVideo