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Volume 7, Issue 6 (Suppl)
J Gastrointest Dig Syst, an open access journal
ISSN: 2161-069X
Page 47
December 07-08, 2017 Madrid, Spain
&
13
th
International Conference on Clinical Gastroenterology & Hepatology
2
nd
International Conference on Digestive Diseases
CO-ORGANIZED EVENT
Clinical Use of Liu-POEM and NOTES
Bingrong Liu
Zhengzhou University, China
Introduction
: With the commencement of clinical use, endoscopy now covers a wide range of usage or clinical examination
and minimally invasive surgery. It is a great trend and reality for such techniques to go further into a state of routine approaches
in clinical practice. Now, I am willing to introduce the excellence of initiation and development of gastrointestinal endoscopy
in three selected facts partly supported by our new development and techniques in our clinical practices and studies.
Liu-POEM: Peroral endoscopic myotomy (POEM):
POEM was developed to provide a minimally invasive treatment for
esophageal achalasia. From this technique, we developed a modified POEM approach and named as Liu-POEM, which is no
need for creating a tunnel and hence shortens operation time and alleviates patient’s pains remarkably. Now, Liu-POEM has
been used by more and more endoscopist in the world.
Background:
Esophageal achalasia is a primarymotility disorder involving absence of esophageal peristalsis, failure of the lower
esophageal sphincter (LES) to relax, and cardiac diastolic dysfunction. Peroral endoscopic myotomy (POEM) has emerged as
an approach to treating esophageal achalasia. Although POEM is credited with high success rates in the treatment of achalasia,
the sub mucosal tunneling is time consuming and commonly requires one-third to two-thirds of the total operation time. For
the purpose of improving POEM procedure and shortening operation time, we modified the POEM procedure by combining
the procedures of myotomy and tunnellization into a unit step. We named this approach as modified per oral endoscopic
myotomy, the Liu-POEM.
Operational procedures:
1) Creation of a 1cmsubmucosal tunnel at the right or back esophageal wall approximately 8 cmproximal to the esophagogastric
junction (EGJ).
2) To cut the circular esophageal muscle fibers to the surface of longitude muscle or cut the full muscle layer using the hook
and IT knives, and at least a 2 cm cutting distal to the EGJ is necessary.
3) The esophageal mucosal entry site was closed with end clips.
In conclusion, Liu-POEM and POEM for the treatment of achalasia has the same therapeutic effect. Liu POEM leads to a
significant decrease in operation time compared with POEM and are possibly contributing to a lower rate of complications.
Further studies are necessary to confirm this.
Pure NOTES
Introduction:
Since Natural Orifice Trans luminal Endoscopic Surgery (NOTES) was first described by Anthony Kalloo, it
has attracted tremendous interest from surgeons and gastroenterologists around. Natural orifice Tran’s luminal endoscopic
surgery (NOTES) uses Trans visceral access to the peritoneal cavity through mouth, rectal, colon, and vagina. Now, a number
of endoscopic approaches canbe performed by NOTES and Pure NOTES. We have performed A series of operations by Pure
NOTES, and the most successful one was transrectal gallbladder preserving cholecyctolithotomy (TRGPC) and transrectal
gallbladder preserving polypectomy (TRGPP) by pure NOTES, which was the first such case series in human beings.
Operational procedures the key steps for TRGPC and TRGPP are as below. Ultrasonic examination was required for disease
confirmation and assessment prior to operation. Under general anesthesia after routine preparations, the patient was placed
in a left recumbent position prior to the initiation of the procedure. A colonoscope was introduced into the transverse colon
and the colonic lumen was cleaned with normal saline through the endoscope and then the endoscope was withdrawn from
the colon. A detachable prototype balloon which was developed by our team was placed into the transverse colon by a biopsy
Bingrong Liu, J Gastrointest Dig Syst 2017, 7:6(Suppl)
DOI: 10.4172/2161-069X-C1-058