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Case Report
Hybrid Natural Orifice Transluminal Endoscopic Surgery with Sentinel Lymph Node Navigation for Deep Early Gastric Cancer in the Fundic Region
Yoon Suk Park, Seong Hwan Kim, Hee Yun Ryu, Young Kwan Cho, Yun Ju Jo, Tae il Son, Young Ok Hong
Clin Endosc 2016;49(3):298-302.   Published online March 29, 2016
AbstractAbstract PDFPubReaderePub
For patients refusing surgical treatment for deep early gastric cancer, hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation is a potential treatment option, particularly when the anatomic location of the cancer has low probability of lymph node metastasis. We report a case of deep early gastric cancer of the fundus beyond the endoscopic submucosal dissection indication that was treated by hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation. In a conventional approach, a total gastrectomy would have been needed; however, the patient refused surgical intervention. In this case, since the patient showed no positivity of the sentinel lymph node on intraoperative navigation, laparoscopic basin lymph node dissection was not performed. Hybrid natural orifice transluminal endoscopic surgery might be considered for specific regions such as the safety zone where lymph node metastases are less likely to occur.


Citations to this article as recorded by  
  • Endoscopic trans-esophageal submucosal tunneling surgery: A new therapeutic approach for diseases located around the aorta ventralis
    Ying Xiong, Qian-Qian Chen, Ning-Li Chai, Shun-Chang Jiao, En-Qiang Ling Hu
    World Journal of Gastroenterology.2019; 25(1): 85.     CrossRef
  • Hysterectomy and salpingo-oophorectomy by transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) assisted by an umbilical camera: Case report and new hybrid technique in gynecology
    Hasan Terzi, Unal Turkay, Navdar Dogus Uzun, Mehmet Salıcı
    International Journal of Surgery Case Reports.2018; 51: 349.     CrossRef
  • Current Status of Endoscopic Resection of Early Gastric Cancer in Korea
    Hwoon-Yong Jung
    The Korean Journal of Gastroenterology.2017; 70(3): 121.     CrossRef
  • 6,873 View
  • 92 Download
  • 3 Web of Science
  • 3 Crossref
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Peroral Endoscopic Myotomy: Establishing a New Program
Nikhil A. Kumta, Shivani Mehta, Prashant Kedia, Kristen Weaver, Reem Z. Sharaiha, Norio Fukami, Hitomi Minami, Fernando Casas, Monica Gaidhane, Arnon Lambroza, Michel Kahaleh
Clin Endosc 2014;47(5):389-397.   Published online September 30, 2014
AbstractAbstract PDFPubReaderePub

Achalasia is an esophageal motility disorder characterized by incomplete relaxation of the lower esophageal sphincter (LES) and aperistalsis of the esophageal body. Treatment of achalasia is aimed at decreasing the resting pressure in the LES. Peroral endoscopic myotomy (POEM), derived from natural orifice transluminal endoscopic surgery (NOTES) and advances in endoscopic submucosal dissection (ESD), presents a novel, minimally invasive, and curative endoscopic treatment for achalasia. POEM involves an esophageal mucosal incision followed by creation of a submucosal tunnel crossing the esophagogastric junction and myotomy before closure of the mucosal incision. Although the procedure is technically demanding and requires a certain degree of skill and competency, treatment success is high (90%) with low complication rates. Since the first described POEM in humans in 2010, it has been used increasingly at centers worldwide. This article reviews available published clinical studies demonstrating POEM efficacy and safety in order to present a proposal on how to establish a dedicated POEM program and reach base proficiency for the procedure.


Citations to this article as recorded by  
  • Esophageal bronchogenic cyst treated with submucosal tunneling endoscopic resection: two case reports
    Hui Sha, Zong-Dan Jiang
    Journal of Medical Case Reports.2024;[Epub]     CrossRef
  • Efficacy of peroral endoscopic myotomy for the treatment of functional esophagogastric junction outflow obstruction
    Madhusudhan R. Sanaka, Prabhat Kumar, Abdul Mohammed, Rajat Garg, Prashanthi N. Thota, Scott Gabbard, Yi Qin, Monisha Sudarshan, Sudish Murthy, Siva Raja
    iGIE.2023; 2(4): 464.     CrossRef
  • Per-oral Endoscopic Myotomy
    Jennifer Liu-Burdowski, Rodrigo Duarte-Chavez, Michel Kahaleh
    Journal of Clinical Gastroenterology.2022; 56(1): 16.     CrossRef
  • How to Develop a Training Program for Third-Space Endoscopic Procedures in Western Countries
    Tony S. Brar, Patrick L. Stoner, Dennis Yang, Peter V. Draganov
    Current Treatment Options in Gastroenterology.2020; 18(2): 232.     CrossRef
  • Establishing a submucosal endoscopy program in a gastrointestinal unit
    Poornima Varma, Payal Saxena
    International Journal of Gastrointestinal Intervention.2020; 9(2): 36.     CrossRef
  • Experience with Peroral Endoscopic Myotomy for Achalasia and Spastic Esophageal Motility Disorders at a Tertiary U.S. Center
    Maen Masadeh, Peter Nau, Subhash Chandra, Jagpal Klair, John Keech, Kalpaj Parekh, Rami El Abiad, Henning Gerke
    Clinical Endoscopy.2020; 53(3): 321.     CrossRef
  • POEM for Treatment of Achalasia: Our Early Experience and Technical Details of the Procedure
    Pravin R. Suryawanshi, Ashok R. Mohite
    Indian Journal of Surgery.2019; 81(5): 452.     CrossRef
  • 2007–2019: a “Third”-Space Odyssey in the Endoscopic Management of Gastrointestinal Tract Diseases
    Anastassios C. Manolakis, Haruhiro Inoue, Akiko Ueno, Yuto Shimamura
    Current Treatment Options in Gastroenterology.2019; 17(2): 202.     CrossRef
  • POEM in Latin America
    Michel Kahaleh, Ming-ming Xu, Felipe Zamarripa, Guadalupe Martínez, Vitor N. Arantes, Fernando Casas Rodriguez, Bismarck Castillo, Iman Andalib, Amy Tyberg, Arnon Lambroza, Monica Saumoy, Juan C. Carames, Alberto Baptista, Carlos Robles-Medranda, Hanna Lu
    Journal of Clinical Gastroenterology.2019; 53(8): e352.     CrossRef
  • An Update on Current Management Strategies for Achalasia and Future Perspectives
    Ioana Smith, Michel Kahaleh
    Journal of Clinical Gastroenterology.2018; 52(4): 277.     CrossRef
  • Treatment of Achalasia with Per-Oral Endoscopic Myotomy: Analysis of 50 Consecutive Patients
    Erica D. Kane, David J. Desilets, Donna Wilson, Marc Leduc, Vikram Budhraja, John R. Romanelli
    Journal of Laparoendoscopic & Advanced Surgical Techniques.2018; 28(5): 514.     CrossRef
  • Per-oral endoscopic myotomy (with video)
    Rahul Pannala, Barham K. Abu Dayyeh, Harry R. Aslanian, Brintha K. Enestvedt, Sri Komanduri, Michael Manfredi, John T. Maple, Udayakumar Navaneethan, Mansour A. Parsi, Zachary L. Smith, Shelby A. Sullivan, Nirav Thosani, Subhas Banerjee
    Gastrointestinal Endoscopy.2016; 83(6): 1051.     CrossRef
  • POEM, the Prototypical “New NOTES” Procedure and First Successful NOTES Procedure
    Robert Bechara, Haruhiro Inoue
    Gastrointestinal Endoscopy Clinics of North America.2016; 26(2): 237.     CrossRef
  • Optical coherence tomography (OCT) prior to peroral endoscopic myotomy (POEM) reduces procedural time and bleeding: a multicenter international collaborative study
    Amit P. Desai, Amy Tyberg, Prashant Kedia, Michael S. Smith, Guadalupe Martinez, Felipe Zamarripa, Yecheskel Schneider, Helga Bertani, Marzio Frazzoni, Fernando Casas, Lauren G. Khanna, Arnon Lambroza, Nikhil A. Kumta, Ali Khan, Reem Z. Sharaiha, Sanjay S
    Surgical Endoscopy.2016; 30(11): 5126.     CrossRef
  • UEG Week 2016 Poster Presentations

    United European Gastroenterology Journal.2016; 4(5_suppl): A157.     CrossRef
  • Idiopathic (primary) achalasia: a review
    Dhyanesh A. Patel, Hannah P. Kim, Jerry S. Zifodya, Michael F. Vaezi
    Orphanet Journal of Rare Diseases.2015;[Epub]     CrossRef
  • Per-Oral Endoscopic Myotomy (POEM) After Previous Laparoscopic Heller Myotomy Is Feasible and Safe in a Porcine Model
    Luke F. Miles, Matthew J. Frelich, Jon C. Gould, Kulwinder S. Dua, Eric S. Jensen, Andrew S. Kastenmeier
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2015; 25(5): 408.     CrossRef
  • Peroral endoscopic myotomy: an evolving treatment for achalasia
    Robert Bechara, Haruo Ikeda, Haruhiro Inoue
    Nature Reviews Gastroenterology & Hepatology.2015; 12(7): 410.     CrossRef
  • 10,291 View
  • 113 Download
  • 18 Web of Science
  • 18 Crossref
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Case Report
Endoscopic Treatment of Various Gastrointestinal Tract Defects with an Over-the-Scope Clip: Case Series from a Tertiary Referral Hospital
Woong Cheul Lee, Weon Jin Ko, Jun-Hyung Cho, Tae Hee Lee, Seong Ran Jeon, Hyun Gun Kim, Joo Young Cho
Clin Endosc 2014;47(2):178-182.   Published online March 31, 2014
AbstractAbstract PDFPubReaderePub

Recently, increasingly invasive therapeutic endoscopic procedures and more complex gastrointestinal surgeries such as endoscopic mucosal resection, endoscopic submucosal dissection, and novel laparoscopic approaches have resulted in endoscopists being confronted more frequently with perforations, fistulas, and anastomotic leakages, for which nonsurgical closure is desired. In this article, we present our experiences with the use of over-the-scope clip (OTSC) for natural orifice transluminal endoscopic surgery (NOTES) closure, prevention of perforation, anastomotic leakages, and fistula closures. The OTSC is a valuable device for closing intestinal perforations and fistulas, for NOTES closure, and for the prevention of perforation after the excision of a tumor from the proper muscle layer. Furthermore, it seems to be quite safe to perform, even by endoscopists with little experience of the technique.


Citations to this article as recorded by  
  • Experimental Evaluation of the Optimal Suture Pattern With a Flexible Endoscopic Suturing System
    Peter Halvax, Michele Diana, Yoshihiro Nagao, Jacques Marescaux, Lee Swanström
    Surgical Innovation.2017; 24(3): 201.     CrossRef
  • Management of non-acute gastrointestinal defects using the over-the-scope clips (OTSCs): a retrospective single-institution experience
    Joshua S. Winder, Afif N. Kulaylat, Jane R. Schubart, Hassan M. Hal, Eric M. Pauli
    Surgical Endoscopy.2016; 30(6): 2251.     CrossRef
  • Early endoscopic closure of colocutaneous fistula adjacent to unmatured low colorectal anastomosis with the Over-The-Scope Clip (OTSC)
    Constantinos Avgoustou, K. Paraskeva
    Hellenic Journal of Surgery.2016; 88(3): 193.     CrossRef
  • Endoscopic Closure for Full-Thickness Gastrointestinal Defects: Available Applications and Emerging Innovations
    Nobuyoshi Takeshita, Khek Yu Ho
    Clinical Endoscopy.2016; 49(5): 438.     CrossRef
  • 6,196 View
  • 59 Download
  • 3 Web of Science
  • 4 Crossref
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