Snare-assisted POEM for Treatment of Esophageal Achalasia

"POEM is performed by using a snare which is retracted into the sheath to expose the tip, leaving a 1-2mm length for operation.~1. After submucosal injection, an initial 2-cm mucosal incision is made by a snare in the posterior esophageal wall.~2. A submucosal tunnel from the esophagus to the gastric cardia is created using a snare.~3. Full-thickness myotomy is performed and extended 2-3 cm beyond the esophagogastric junction (EGJ) using a snare.~4. The mucosal incision is closed with endoclips."

"POEM is performed by using a conventional endoscopic knife.~1. After submucosal injection, an initial 2-cm mucosal incision is made by a knife in the posterior esophageal wall.~2. A submucosal tunnel from the esophagus to the gastric cardia is created using a knife.~3. Full-thickness myotomy is performed and extended 2-3 cm beyond the esophagogastric junction (EGJ) using a knife.~4. The mucosal incision is closed with endoclips."