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Achalasia is an uncommon esophageal motility disorder in which there is selective loss of inhibitory neurons resulting in loss of peristalsis and failure of adequate relaxation of the lower esophageal sphincter (LES) in response to food bolus. There is no current curative treatment that reverses the pathophysiology of achalasia. The treatment options are aimed at improving the passage of solids and liquids through the gastroesophageal junction (GEJ). The traditional treatment options include surgical myotomy and endoscopic methods that disrupt or weaken the LES, such as endoscopic balloon dilation and botulinum toxin injection (BI).

Per-Oral Endoscopic Myotomy (POEM) represents a Natural Orifice Translumenal Endoscopic Surgery®(NOTES®) approach to Heller myotomy. Preliminary data suggest that this minimally invasive endoscopic procedure may achieve clinical results similar to those of surgical …