Medical Mystery Solved!
Unique, incision-less surgery closes the case on a rare esophageal disorder.
THE SYMPTOMS CHARLENE GORDON EXPERIENCED ARE TYPICAL FOR ACHALASIA. Everything she tried to eat or drink came back up. She couldn’t sleep and had lost about 50 pounds. “I even stopped cooking, because I wasn’t able to eat,” she says.
Achalasia, a condition that prevents the muscles at the bottom of the esophagus from relaxing, is a rare disorder that affects one in 100,000 people, according to Steve Zeddun, MD, Assistant Professor of Medicine, Gastroenterology and Liver Diseases at the George Washington University Hospital. A new treatment for achalasia, PerOral Endoscopic Myotomy (POEM), has been developed that involves incision-less “surgery” via a natural orifice: the mouth. “The procedure is very complex. You need specialized skills and know-how,” says Dr. Zeddun. “There are fewer than 10 centers in the United States that do this.”
During a POEM procedure, an endoscope is inserted through the mouth and tunneled within the esophagus. This allows surgeons to access and cut abnormal muscle fibers restricting the valve at the base of the esophagus. By dividing the muscles, the esophagus opens normally and allows food and liquids to enter the stomach.
“Previously, this was done through a large incision in the chest several decades ago, then evolved to smaller incisions in the abdomen. Presently, the POEM doesn’t entail any incisions,” says Fred Brody, MD, Director of Minimally Invasive Surgery and Professor of Surgery at GW Hospital. “We prefer the endoscopic, minimally invasive technique. We see faster recovery and significantly less pain, if any.”
Gordon, a nurse and Washington, DC resident who was treated by Drs. Brody and Zeddun, says, “Everything went well. After surgery, the first thing I ate after a week without solid food was a hamburger. When it stayed down, I was so happy!”