In vivo experience with peroral endoscopic myotomy: An essential activity for developing the technique in humans

Peñaloza-Ramírez, Arecio; Suárez-Correa, J.; Báez-Blanco, J.; Sabogal-Gómez, C.; Kuan-Casas, Hernando; Sánchez-Pignalosa, C.; Aponte-Ordóñez, Pedro

doi:10.1016/j.rgmxen.2017.05.008

Cited by 1 publication

(1 citation statement)

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“…The trainee was expected to have observed at least 20 cases by experts and completed at least five POEMs in animal models before performing selected portions of POEM in human cases under supervision in the latter portion of phase 2. These thresholds were based on the suggested ESGE training curriculum for submucosal endoscopy and prior studies using animal models for POEM training [22,25,26]. In phase 3, POEM cases were partially or completely performed by the trainee under direct supervision [15].…”

Section: Poem Training Curriculummentioning

confidence: 99%

Pilot prospective study on formal training in per-oral endoscopic myotomy (POEM) during advanced endoscopy fellowship

et al. 2021

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Background and study aims Gastroenterology societies have recently proposed core curricula for training in per-oral endoscopic myotomy (POEM) based on expert opinion with limited data on its applicability for advanced endoscopy fellowship (AEF) trainees. We prospectively evaluated the feasibility of a structured POEM training curriculum during a dedicated AEF and the trainee’s performance during independent practice. Methods This was a single-center prospective study evaluating a trainee’s performance of POEM using a structured assessment tool (POEMAT) to assess core cognitive and technical skills. The trainee’s performance was then prospectively assessed during the first 12 months of independent practice. Results The trainee, who had not prior background in submucosal endoscopy, first observed 22 POEM cases followed by 35 hands-on procedures during his advanced endoscopy fellowship. Based on the POEMAT, submucosal entry and mucosal incision closure were the most challenging technical aspects, while cognitive skills were uniformly attained early in training. Overall, the trainee was able to cross the threshold for competence in his POEMAT performance score in 15 of his last 18 cases (83.3 %). The trainee performed 16 POEMs (baseline mean Eckardt 7.2) in his first 12 months of independent practice. Mean procedural time was 79.8 minutes (interquartile range: 67–94 minutes minutes) with no adverse events. Clinical success (Eckardt score < 3) was achieved in 100 % of the cases at a median follow-up of 20 weeks. Conclusions Results from this pilot study support the adoptability of the recently proposed core curricula for POEM training within the context of a dedicated AEF and provide a potential blueprint for future studies of performance in POEM among trainees.

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