POEM using HybridKnife®

Indications

  • Esophageal motility disorders
  • Achalasia
  • Dysphagia

Advantages of ERBE equipment

  • Waterjet and electrosurgery in a single instrument
  • Shorter operation times
  • Minimally-invasive surgical procedure
  • Expansion of the submucosa as a result of the separation medium
  • Tunnel dissection of the muscularis beneath the mucosa
  • Fast convalescence as the mucosa covers the cut following surgery

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Operation steps
Elevation

Elevation

With the HybridKnife's water jet, the mucosa is lifted above the initial esophageal stenosis. The separation medium accumulates layer-specific and forms a submucosal cushion.

Incision / Dissection

Incision / Dissection

Using the electrosurgical function of the HybridKnife, the mucosa is opened to a length of approx. 2 cm above the stenosis.

Preparation

Preparation

A submucosal tunnel is exposed while alternating between the water jet and the electrosurgical function. The mucosa is protected from mechanical and thermal damage as a result of the elevation that can be replenished at any time during preparation. Exposure is performed to approximately 2 cm below the gastroesophageal junction.

Myotomy

Myotomy

In subsequent myotomy, the annular muscle is cut with the HybridKnife electrosurgical function. The opening of the incision in the mucosa is then closed with clips.