P.O.E.M. Procedure: What the Radiologist Needs to Know for This New Surgical Intervention for Achalasia

Achalasia is a debilitating condition resulting from the failure of appropriate lower esophageal sphincter (LES) relaxation. Traditionally, the treatment of choice for achalasia has been a Heller myotomy, performed either via laparotomy or laparoscopically. The latter method has gained wide popularity in its documented lower postoperative morbidity. Recently, however, a new technique has been developed that can be performed by both thoracic surgeons and endoscopists: Per-Oral Endoscopic Myotomy (POEM). This procedure offers an alternative to invasive surgery, and provides excellent outcomes with minimal recovery time [1]. This article will help familiarize radiologists with this new technique, as well as both normal and abnormal post-operative appearances.