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PERORAL GASTRIC ENDOSCOPIC MYOTOMY
Stephanie M. Novak*1, Zachary M. Callahan1,2, Michael Ujiki1
1General Surgery, NorthShore University Health System, Evanston, IL; 2General Surgery, Thomas Jefferson University, Philadelphia, PA

We present a video of a PerOral Gastric Endoscopic Myotomy. The patient is a 77-year-old male who underwent minimally invasive esophagectomy after neoadjuvant chemotherapy and gastric preconditioning. He developed postoperative dysphagia due to moderate pyloric stenosis. His preoperative gastric emptying study showed gastric retention at four hours. During the operation, an impedance planimetry catheter measured pyloric distensibility. Submucosal tunneling was achieved with the Hybrid I-Knife. A pyloromyotomy was performed and the mucosal defect was closed with clips. The patient was discharged on postoperative day 0. Postoperative imaging showed marked improvement of his gastric emptying.


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