Peroral endoscopic myotomy, a laparoscopic procedure, adds a submucosal tunnel to access and dissect the muscular circular layer of the esophagus.
This procedure reduces post myotomy reflux without an additional fundoplication and may potentially reduce the incidence of carcinoma.
Peroral endoscopic myotomy is a less invasive procedure with minimal complications.
Patients are generally discharged to home the day after the procedure on a liquid diet, and few subsequently complain of reflux symptoms.
Success rates have reportedly been 89% to 100% over a 6-month period.
Studies with longerterm follow-up show decreasing efficacy, with rates from 82% at 1 year to 80% after 2 years.
Serious complications were reported to be low.
Reflux esophagitis occurs approximately 18% of the time and requires treatment with long-term proton pump inhibitors.