SRM MEDICAL COLLEGE AND HOSPITAL & RESEARCH CENTRE JOINS ELITE LEAGUE OF PRIVATE HOSPITALS TO PERFORM PER-ORAL ENDOSCOPIC MYOTOMY

• The operation was performed by SRM Medical College Hospital and Research Centre’s interventional endoscopic gastro enterologist Dr N A Rajesh under the overall supervision of chief surgical gastro enterologist Dr. A. Rathnaswami.

Chennai, August, 2019: SRM Medical College Hospital and Research Centre, Kattankulathur, Holding out hope for people suffering from ACHALASIA, a rare disorder of Esophagus causing difficulty in swallowing food, a Per-Oral Endoscopic Myotomy, an advanced Endoscopis procedure has been performed for the first time at SRM Medical College Hospital and Research Centre, Kattankulathur, COO Dr. Ram Natesan has said.

“A 45-year-old gentleman presented himself before us with difficulty in swallowing he has suffered for over three months. He had difficulty in eating and complained of vomiting of food immediately after eating. He was evaluated with Upper GI Endoscopy, Barium Swallow and Oesophageal Manometry and was diagnosed to have a rare oesophageal disorder known as Achalasia Cardia. We gave him the option to correct his problem endosopically and he agreed, knowing that we are going to perform this procedure for the first time. He underwent Per-Oral Endoscopic Myotomy (POEM) procedure in SRM Hospital recently,”  Dr.Rajesh said.;

Elaborating, Dr Rajesh said the procedure was conducted without any glitches and the patient tolerated the procedure well. He recovered well, was given fluids the next day and regular diet the third day. One month after the procedure now, he is eating well without vomiting. The procedure was first introduced in 2008 in Japan and is currently done only in a few advanced endoscopic centres in India. This procedure requires, apart from specializaed endoscopic equipment, a skilled endoscopist with adequate training in therapeutic Endoscopic procedures.

“Such advanced endoscopic facilities and skill and knowledge of therapeutic endoscophy is available in Gastroenterology Department of SRM Medical College Hospital and Research Centre, thanks to the administrators and management which evinces keen interest in assisting us to develop the endoscopic centre as a „Centre of Excellence in Therapeutic Endoscopy,” said Dr. Rajesh.

Indeed this procedure has been done at the SRM Medical College Hospital and Research Centre for the first time. At present only three centres in Chennai – GLOBAL, GEM, and Medindia Hospitals in private sector perform this advanced Endoscopic Procedure. Department of Gastroenterology, SRM Medical College Hospital and Research Centre shares its pride in being the first medical college in Chennai to perform this advanced endoscopic procedure, Dr Rajesh added.

ABOUT ACHALASIA:

ACHALASIA is a rare disorder of Esophagus causing difficulty in swallowing food. It is caused by damage to the nerves that supply the esophagus. This results in failure of relaxation of sphincter muscle in the lower end of the oesophagus the valve which usually allows food to go from food pipe to stomach. Failure of relaxation of valve prevents food to go into the stomach and the patient has difficulty in swallowing.

Achalasia can be diagnosed by (a) Barium Swallow- X-ray of chest taken after swallowing of a liquid solution called Barium. (b) Upper GI Endoscopy – A fliexibe tube with light and camera inserted through mouth to inspect esophagus and stomach. (c) Esophageal Manometry Gold standard in diagnosis, measures esophagus contraction and LES
relaxation.

TREATMENT:
Achalasia treatment is focused on forcing open the non-relaxing valve. This is achieved by dividing the sphincter muscle- the Valve. This cutting of the muscle which remains tight is done by surgery, and it is known as Heller‟s Cardio Myotomy. This procedure is done over the years by minimally invasive Laparoscopic surgery and remained as Gold standard for this condition over the years. POEM is a novel procedure, where the cutting of the sphincter can be achieved endoscopically without any incision over the body. That is without Laparoscopic surgery.

In Per Oral Endoscopic Myotomy (POEM) endoscope is inserted through the mouth and a tunnel is created between the lining of the oesophagus and muscle, by making a hole in the lining membrane- the mucosa. Subsequently the muscle at the lower of oesphageal sphincter cut endoscopically. Finally, the opening in the lining membrane is closed with  clips.

POEM procedure offers long term symptomatic relief comparable to surgical H Cardiomyotomy. It does not require any abdominal incisions and requires minimal Hospital stay. POEM can also be done in patients who failed to get well after laparoscopic treatment.