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).
Dr Zaheer Nabi,
Consultant Gastroenterologist
Asian Institute of Gastroenterology,
Hyderabad, India
