Third-space endoscopy: the final frontier

Over the years, our growing experience with endoscopic submucosal dissection along with technological advances has solidified our comfort and knowledge on working in the submucosa, also referred to as the third space. Per-oral endoscopic myotomy (POEM) was the first prototype third-space endoscopy (TSE) procedure, demonstrating the feasibility and clinical utility of endoscopic esophagogastric myotomy via submucosal tunneling. The launch of POEM accelerated the evolution of TSE from a vanguard concept to an expanding field with a wide range of clinical applications. In this review, we discuss the status and future directions of multiple TSE interventions.

Automated summary

Over the years, our experience with endoscopic submucosal dissection and technological advances has improved our understanding of working in the submucosa. Per-oral endoscopic myotomy (POEM) was the first procedure to demonstrate the feasibility and clinical benefits of endoscopic esophagogastric myotomy. The launch of POEM has accelerated the development of third-space endoscopy with various clinical applications.