scholarly journals S0346 Prospective Pilot Study Evaluating Training in Per-Oral Endoscopic Myotomy (POEM) Using a Standardized Assessment Tool (STAT)

2020 ◽  
Vol 115 (1) ◽  
pp. S170-S170
Author(s):  
Salmaan A. Jawaid ◽  
Hiroyuki Aihara ◽  
Mouen Khashab ◽  
Peter Draganov ◽  
Dennis Yang
Keyword(s):  
Pilot Study ◽  
Assessment Tool ◽  
Standardized Assessment ◽  
Prospective Pilot Study ◽  
Per Oral Endoscopic Myotomy ◽  
Endoscopic Myotomy ◽  
Per Oral

scholarly journals Per-oral endoscopic myotomy (POEM) training and skills evaluation tool: a pilot study

2020 ◽  
Vol 08 (12) ◽  
pp. E1826-E1831
Author(s):  
Alexander Schlachterman ◽  
Ahmed Aziz ◽  
Bader Alajlan ◽  
Samuel Han ◽  
Jorge Machicado ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cognitive Skills ◽  
Assessment Tool ◽  
Technical Skills ◽  
The United States ◽  
Evaluation Tool ◽  
Per Oral Endoscopic Myotomy ◽  
Hands On ◽  
Endoscopic Myotomy ◽  
Per Oral

Abstract Background and study aims Hands-on training for per-oral endoscopic myotomy (POEM) in the United States is limited and without a structured curriculum or assessment tool. Training to competency in POEM is critical and POEM trainees must acquire multiple cognitive and technical skills to achieve proficiency. The aim of this study was to develop a POEM training and skills evaluation tool. Patients and methods The training protocol included initial explant porcine models followed by live human cases, proctored by a single endoscopist experienced in POEM who prospectively graded trainees for each step (“skill”) of the procedure on a 5-point scale. Procedural skills were divided into cognitive and technical skills. Acceptable passing level was considered a score ≥ 4 for each skill. Results Three trainees completed a total of 18 cases (8 cases on animal explant models and 10 human cases). Overall, cognitive skills were acquired early in training with scores of ≥ 4 achieved by ≤ 3 cases. Technical skills required more cases and direction with scores ≥ 4 in technical skills achieved by three porcine and eight human cases. Entry of the endoscope into the submucosal space and submucosal tunneling were the most challenging steps followed by myotomy. Conclusion This pilot study introduces a POEM training and skills evaluation tool for training to competency. Submucosal entry, tunneling, and myotomy were the most challenging to learn while cognitive skills were learned early in training. Evaluation of more trainees at multiple sites will be necessary to further validate the utility of this tool.

scholarly journals Pilot prospective study on formal training in per-oral endoscopic myotomy (POEM) during advanced endoscopy fellowship

2021 ◽  
Vol 09 (12) ◽  
pp. E1890-E1899
Author(s):  
Salmaan Jawaid ◽  
Peter V. Draganov ◽  
Hiroyuki Aihara ◽  
Mouen A. Khashab ◽  
Dennis Yang
Keyword(s):  
Prospective Study ◽  
Cognitive Skills ◽  
Assessment Tool ◽  
Clinical Success ◽  
Independent Practice ◽  
Per Oral Endoscopic Myotomy ◽  
Core Curricula ◽  
Eckardt Score ◽  
Endoscopic Myotomy ◽  
Per Oral

Abstract Background and study aims Gastroenterology societies have recently proposed core curricula for training in per-oral endoscopic myotomy (POEM) based on expert opinion with limited data on its applicability for advanced endoscopy fellowship (AEF) trainees. We prospectively evaluated the feasibility of a structured POEM training curriculum during a dedicated AEF and the trainee’s performance during independent practice. Methods This was a single-center prospective study evaluating a trainee’s performance of POEM using a structured assessment tool (POEMAT) to assess core cognitive and technical skills. The trainee’s performance was then prospectively assessed during the first 12 months of independent practice. Results The trainee, who had not prior background in submucosal endoscopy, first observed 22 POEM cases followed by 35 hands-on procedures during his advanced endoscopy fellowship. Based on the POEMAT, submucosal entry and mucosal incision closure were the most challenging technical aspects, while cognitive skills were uniformly attained early in training. Overall, the trainee was able to cross the threshold for competence in his POEMAT performance score in 15 of his last 18 cases (83.3 %). The trainee performed 16 POEMs (baseline mean Eckardt 7.2) in his first 12 months of independent practice. Mean procedural time was 79.8 minutes (interquartile range: 67–94 minutes minutes) with no adverse events. Clinical success (Eckardt score < 3) was achieved in 100 % of the cases at a median follow-up of 20 weeks. Conclusions Results from this pilot study support the adoptability of the recently proposed core curricula for POEM training within the context of a dedicated AEF and provide a potential blueprint for future studies of performance in POEM among trainees.

scholarly journals Experience and Technique for Zenker's Diverticulum Per Oral Endoscopic Myotomy: Z-POEM

2020 ◽  
Author(s):  
Eitan Podgaetz ◽  
Vani Konda
Keyword(s):  
Third Space ◽  
Zenker’S Diverticulum ◽  
Complication Rates ◽  
Short Term ◽  
Zenker's Diverticulum ◽  
Per Oral Endoscopic Myotomy ◽  
Endoscopic Myotomy ◽  
Invasive Techniques ◽  
Per Oral

Abstract Objective With the advent of minimally invasive surgery, incisionless surgery, and third-space endoscopy, the treatment for Zenker's diverticulum has also moved toward less invasive techniques Methods New incisionless per oral techniques can be applied for cricopharyngeal myotomy in Zenker's diverticulum. Results Five patients underwent Zenker's diverticulum per oral endoscopic myotomy (Z-POEM) without complications, minimal discomfort, and narcotic consumption, with complete resolution of their symptoms by history and Eckardt scores. Conclusions Z-POEM is performed entirely endoscopically with very little associated pain or complication rates, with short-term follow-up having excellent functional and symptomatic results.

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