POEM Surgery

Hi Fay,

Sorry to hear that you are unable to keep solid foods down. Is this something

I wanted to learn if there were any complications during the POEM. My daughter is scheduled for POEM on Feb-02 at USF. And we are very nervous, any advise you could share is much appreciated.

Regards,

Hi Ravavi,

So sorry to hear you're daughter has achalasia. You do not say what type, but I would highly recommend POEM if her esophagus does not have peristaltic waves. This action moves the food down to the LES muscle which opens to allow food in and then closes back to normal.

Tell her to wait at least 10 days after the surgery before trying to bend over or whatever is in her stomach will come back up.

The surgery is very safe in the right surgeons hands.

Wishing you're daughter the very best.

Regards,

Fay

Hi Fay,

She has Type-2 Achalasia.Thanks for your response. I will share this info with her.

Ravavi

I had my POEM done at the Cleveland Clinic, by Dr. Raja, on 12-23-16.

Three days post surgery, I am doing very good.

I had type 3 A, and my procedure involved cutting not only the muscles around the LES, also some of the inner muscles higher up in my esophagus, because of spasms. Saturday, I had some minor spasms, that I am guessing was where the incision was made.

Since then, no spasms, and only minor pain.

One more day of clear liquids, before moving to a full liquid diet for a week, then introducing "soft" foods a little at a time, over the next two months.

My only suggestion with your daughter, would be to do research and ask the surgeon lots of questions, including how many POEM's have you done, in the past year.

Cleveland Clinic is one of the better places to go, in the US, for Achalasia, and they only perform about 2-3 POEM's a week. Dr. Raja does most of them.

In other words, he he doing over 100 a year.

POEM is not a difficult surgery to perform, according to Dr. Raja, but it can be messed up really quick by someone without the experience of having done multiple procedures. The biggest problem could be a perforation of the esophagus wall, which could require regular surgery to repair.

Again, do your research and make sure that the surgeon is very experienced with performing POEM's.

Hi Timeenuf,

Sincerely appreciate your response. Dr. Velanovich has performed about 34 to 35 surgeries, based on what I have learnt. So we are thinking we should be in good hands.

Regards,

I remember reading somewhere that the learning curve for doing the procedure was around 20, so she should be in good hands.

I wish her the best with the surgery.

How did the surgery go. My wife and I are in the consultation phase of the surgery for her. She's had an extreme case with esophageal spasms for over 5 years now. We've been doing the Botox injections which seem to work for a while but now that want to do this surgery. My concern is the after effects with keeping food down and spasms. I was also wondering about the bending over. Can you eventually be able to bend or is that muscle always open causing everything to come out. Increased acid reflux? Hope everything is well

There is also a Dr Stravropoulos at Winthrop Hospital in NY who has done over 400 POEM procedures. If you would like his info just let me know.

Well we are currently seeing a doctor in Hershey pa. I understand he's supposed to be good.

Do yourself a huge favor and find out how many POEM procedures he has personally done. Not watched or assisted. Done himself!!!! These doctors like us to think they have done way more than what they truly have. My doctor that did my POEM told me he had done 65+. Later I came to find out at that time he had only done around 20-25. Big difference. Now granted, cutting out the muscle is not that hard but getting to it properly can use a little finesse. The doctor that did my latest surgery/procedure on my esophagus has done over 400 POEM Procedures and that is the only reason I let him do this brand new procedure which was a plication via an overstitch . I to was misdiagnosed for 6 years and it seemed hopeless. All kinds of stupid treatments that did nothing.

I hope your wife has a good procedure and recovers quickly.

Thanks that's one of the many questions we have

How is it after surgery for you. Any problems?

Yes , after the poem I had terrible acid attacks every morning I was awakened about 2 hrs after laying down. There was nothing stopping it from coming up my esophagus.

Hi Larry - Unfortunately I never recovered from the POEM surgery.  As I explained earlier I have Jackhammer esophagus DCI was way above 8500 on high resolution manomentry.  I had the POEM surgery 10/3/2016 and starting in early December, I could not keep any solids down. I went back to the surgeon who performed another endoscope to view the incision site and LES. Based on this test and an esophogram, all was normal, so I tried to live with my condition until end of January 2017 when my stomach refused all but 2 to 3 oz of water every couple hours.  I was put on IV hydration support and ended up having a partial Nissen Fundiplication on March 6th.  The doctors cannot cure the condition they only treat the symptoms.  I returned to work on March 28th.  I can keep food down now and it does not come back up when bending over.  I lost 30lbs since January which the doctors are watching.  For severe chest spasms my doctor has me on a low dose nitro patch I wear for 12hrs per day, plus a 5mg valium 3x a day also reduces the spasms as it is a muscle relaxer.  Wishing everyone suffering from these conditions the very best.  The POEM surgery did get rid of the dysphagia.  I consider that a big achievement. 

Wow I'm sorry for all that. My wife has a severe case as we'll we are hoping for a good result. It's been 10 years of misery for her with cycles of some good days but mostly bad ones. They have her on all that plus pain meds. She's on diltiazam for spasms. It's a calcium channel blocker. Maybe that's an option. Our thoughts and prayers are with you

I am now into my 3rd year dealing with this condition.  The doctors tried all types of medication to control my symptoms.  I have endured 10 endoscopic dialation procedures, botox injections, Omeprazole (PPI), Reglan, ect, plus they even had me on Zofran and Phenergan at the same time to control the constant nausea, which I still take Phenergan after the surgery; however, I was able to stop the Zofran. 

I feel for your wife and wish her well, as I know if she is like me the spasms are extremely painful.  The doctors at first though I was having a heart attack and performed a bunch of test.  All came back normal including cardio cath.

Thank you for the prayers and I will pray for your wife too.

His name is Dr Matthews. He's done about 70 of the procedures and all but one had complications. Apparently he knows the doctor from Japan that did the first one. It sounds really good and we are gonna do it. Praying for a positive outcome. At this point this is all that's left.

Hey Larry, I'm not sure about what you said, all but just one had complications? That's not a very good track record. As far as knowing the Dr from Japan, my doctor is the one who trained with him and brought it from Japan to the United States. That said, if he's done 70 why is he still having complications? What state are you located in ? Unless I misunderstand what you were saying and out of 70 only had one with complications. I truly hope if you proceed with him that everything goes well . Does he use clips and if so how many ? Also find out his diet plan, how long on clear liquids after and how long on full liquids? What's his plans for test after and what's the time frame. You should have these answers before you lay down on the steel table. Good luck I wish you guys well.

Hi Robert, Would you please kindly share the information about your doctor?

My POEM was denied by the insurance. The doctor and the hospital is trying to follow next steps, although I am not clear what they are. I opted for Heller first and then later changed to POEM. Was your procedure denied in the first place? Can you please share your story as well?

Thank you,

​Pratik