Case Study

POEM with Septotomy in a Case with Large Epiphrenic Diverticulum Using A Novel Bipolar Speedboat Device

A 62-year-old gentleman presented with dysphagia to solids, regurgitation and chest pain for five-years. Evaluation with endoscopy revealed a dilated oesophagus and resistance at the gastroesophageal junction. In addition, a large epiphrenic diverticulum was noticed at the lower end of the oesophagus. 

High resolution oesophageal manometry suggested type I achalasia cardia. Per-oral endoscopic myotomy (POEM) was planned in this case.

POEM with division of the septum was performed via the posterior route (5 o’clock). In this case series, we used a novel bipolar device (Speedboat Inject). This device uses advanced bipolar radiofrequency (RF) energy for submucosal dissection (400KHz and 35W) and microwave energy for coagulation (frequency 5.8 GHz, power setting 10W). 

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Dr Zaheer Nabi

Dr Zaheer Nabi,
Consultant Gastroenterologist

Asian Institute of Gastroenterology,
Hyderabad, India

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