New endoscopic procedure for achalasia cardia patients

Tribune News Service 

Chandigarh, August 5  

The Department of Gastroenterology at the PGIMER, Chandigarh, has developed a new third space endoscopic procedure for achalasia cardia patients. 

Prof Rakesh Kochhar, head of the department of gastroenterology, said peroral endoscopic myotomy had emerged as an endoscopic choice for treatment of achalasia cardia with good results and had emerged as the first line therapy for this condition.

Prof Usha Dutta said achalasia cardia was a common disorder of the motility of the food pipe, where the patients find difficulty in swallowing liquids and solids. The diagnosis was done by measurement of esophageal pressures during manometry. 

The PGIMER uses state of high resolution manometry to diagnose and characterise this condition. In this condition, the pressure of the lower esophageal sphincter, are increased and the treatment involves cutting some of the muscle fibers of this sphincter to partially release the excess pressure. Earlier, these muscle fibers were cut surgically, but with POEM it is possible to do the same endoscopically without any surgical scar. 

Prof Kochhar said the department was already providing endoscopic dilatation and botulinum injection therapy for patients and with addition of POEM, patients of the region would benefit.

“The procedure paves way for addition of various other third space endoscopic procedures and submucosal procedures at the PGIMER. These procedures are aimed at being minimally invasive, through endoscopes and avoid major surgery. However, we need to create operation theatre-like facility in the endoscopy suites, train our doctors, technicians and nursing staff and support from anaesthesia team,” added prof Kochhar.

Spokesperson of the PGIMER said the department was committed to provide POEM therapy at affordable costs to patients. 

Dr Zaheer from the Asian Institute of Gastroenterology, Hyderabad, participated as an expert during a workshop on the new procedure on Sunday. 

The workshop was conducted with the help of Dr Komal Gandhi from the department of anaesthesia and Prof Arunanshu Behera from the department of general surgery.