Technical review of gastric per-oral endoscopic myotomy

Gastroparesis, or symptomatic delayed gastric emptying, has seen a startling increase in prevalence of over last decade. Efficacy of initial dietary and medical therapies remain limited and patients that fail these first line remedies represent a significant therapeutic challenge. Recent procedural and technological advancements have led to the development of a promising endoscopic therapy for gastroparesis via an endoscopic pyloromyotomy, also referred to as gastric per-oral endoscopic myotomy (G-POEM) or per-oral endoscopic pyloromyotomy (POP). While initial preliminary reports of G-POEM or POP for the treatment of gastroparesis are encouraging, there is not a consensus standardized procedural approach and published practice patterns at each stage of the G-POEM procedure can vary wildly. The aim of our review is to provide an overview of the technical aspects of the G-POEM procedure framed within our current practice patterns and that of the published literature. Copyright (C) 2019, Society of Gastrointestinal Intervention.