Chair: Chair: Arghavan Salles, MD
Faculty: Prakash Gyawali, MD; Eric Pauli, MD; and William Richards, MD
Program Outline:
– Welcome and Overview – Arghavan Salles, MD
– Work-up of Achalasia – Arghavan Salles, MD
– Manometry and non-operative Management Options – Prakash Gyawali, MD
– Heller Myotomy – William Richards, MD
– POEM – Eric Pauli, MD
Achalasia diagnosis & work-up by Arghavan Salles–2:33
Pt presentation–2:56
Differential dx–3:40
Achalasia definition–5:57 Nat Rev Gastroenterol Hepatol 2011
Work-up–7:05
Eckardt score–8:57
Barium swallow–9:55
Upper endoscopy–10:33 Nat Rev Gastroenterol Hepatol 2015
High-resolution manometry–11:17
Chicago classification–12:38
Tx options–14:33
Achalasia: Manometry & non-operative management options by C. Prakash Gyawali–16:26
Achalasia overview–17:17
HRM plot–19:21 Gastroenterology 1994
Integrated relaxation pressure key determinant of EGJ transit–21:08 Neurogastroenterol Motil 2013
Failure of LES to relax–24:30 Neurogastroenterol Motil 2017
Histopathology in achalasia–25:55 Neurogastroenterol Motil 2016
2 pathways of inhibitory dyfunction–27:43 Gastroenterology 2013
Achalasia modern concepts–32:27 Neurogastroenterol Motil 2016
Clinical manifestations–35:15 J Gastrointest Surg 2015
Manometry: Hierarchial approach–36:26 Neurogastroenterol Motil 2015
Potential pitfalls & caveats–39:29 Gastrointest Endosc Clin N Am 2014
Impedance-pressure topography–41:02 Am J Gastroenterol 2014
Endo-FLIP in achalasia–42:03 Neurogastroenterol Motil 2013
Tx of achalasia & spastic disorders–44:39
Mechanism of action–44:58 Neurogastroenterol Motil 2011
Smooth muscle relaxants in achalasia & spastic disorders–47:53
Pneumatic dilation–49:40 Gut 2011
Achalasia management options–51:22 Gastroenterology 2013
Curr Treat Options Gastroenterol 2014
Tx of achalasia–52:02 Am J Gastroenterol 2013
Summary–54:01
Heller/Dor for achalasia by William O. Richards–55:06
Rationale for Heller/Dor in achalasia–56:19
GERD after Heller or POEM impaired anti-reflux barrier–56:46
LES length & pressure are both important for an effective anti-reflux barrier–57:39
Mechanisms of GERD–59:33
Pertinent literature–59:55 Ann Surg 2004
Heller with Dor fundoplication–1:07:22
Procedural video clip–1:08:54
Conclusion–1:15:23
POEM by Eric M. Pauli–1:16:28
Why POEM?–1:18:38
Development of endoscopic myotomy–1:20:19 Gastrointest Endosc 1980
Technical refinement–1:22:50 Surg Endosc 2008
The 1st POEM–1:23:38 Endoscopy 2010
Technical steps–1:24:55 J Gastrointest Surg 2012
Technique changes–1:34:50
Post-op management–1:36:50
Complications–1:39:14
Results: Safety/efficiency–1:42:29 Surg Endosc 2015
Results: Post-op issues–1:45:57 Surg Endosc 2017
Results: Durability–1:47:02 JACS 2015
Conclusion–1:47:31