SRM Medical College Hospital and Research Centre joins elite league of private hospitals to perform PER-ORAL ENDOSCOPIC MYOTOMY


SRM Medical College Hospital & Research Centre joins elite league of private hospitals to perform      PER-ORAL ENDOSCOPIC MYOTOMY

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.

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.

“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 specialized endoscopic equipment, a
skilled endoscopist with adequate training in therapeutic Endoscopic

“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


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

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


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

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.