SAGES Webinar: Work-up and Treatment of Achalasia (February 2017)

 

Webinar Chair: Chair: Arghavan Salles, MD

  1. Welcome and Overview | Arghavan Salles, MD
  2. Work-up of Achalasia | Arghavan Salles, MD
  3. Manometry and non-operative Management Options | Prakash Gyawali, MD
  4. Heller Myotomy | William Richards, MD
  5. 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

Ann Gastroenterol 2015

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

Am J Gastroenterol 1999

Smooth muscle relaxants in achalasia & spastic disorders–47:53

Pneumatic dilation–49:40 Gut 2011

Therap Adv Gastroenterol 2013

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

J Gastrointest Surg 2016

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

Surg Endosc 2015 Orenstein SB

Results: Post-op issues–1:45:57 Surg Endosc 2017

Results: Durability–1:47:02 JACS 2015

Conclusion–1:47:31

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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