Underwater coagulation using hybrid knife in peroral endoscopic myotomy for achalasia
Antonio Capogreco, Roberto de Sire, Davide Massimi, Ludovico Alfarone, Roberta Maselli, Cesare Hassan, Alessandro Repici
Abstract
Achalasia is an idiopathic esophageal motility disorder, characterized by the insufficient relaxation of the lower esophageal sphincter and the absence of peristalsis in the esophageal body, leading to disabling symptoms, such as dysphagia, regurgitation, chest pain, and weight loss [1]. Until a few years ago, common interventional therapeutic approaches included botulinum toxin injection, endoscopic pneumatic balloon dilation, and laparoscopic Heller myotomy. Nevertheless, the first options have proved to be of only limited efficacy, while the surgical approach is highly invasive, costly, and burdened by potential severe complications and long recovery times [2].