Third Space Endoscopy is an advanced field of therapeutic endoscopy that allows doctors to perform minimally invasive procedures within the wall of the gastrointestinal tract.
These techniques can be used to treat several complex digestive disorders and remove selected gastrointestinal tumors without the need for traditional surgery in many cases.
Third Space Endoscopy includes advanced procedures such as POEM, G-POEM, Z-POEM, ESD, STER, and EFTR.
POEM for Achalasia
POEM, or Peroral Endoscopic Myotomy, is a modern endoscopic technique used to treat achalasia.
Achalasia is a condition in which the lower esophageal sphincter fails to relax properly, making it difficult for food and liquids to pass from the esophagus into the stomach.
Symptoms of Achalasia
Common symptoms may include:
- Difficulty swallowing.
- Chest pain during swallowing.
- Regurgitation of food into the esophagus.
- Weight loss.
- Bad breath.
How POEM Works
POEM is performed through the mouth using a flexible endoscope. During the procedure, the doctor creates a small tunnel within the esophageal wall and cuts the affected muscle to help improve swallowing and allow food to pass more easily into the stomach.
G-POEM for Gastroparesis
G-POEM, or Gastric Peroral Endoscopic Myotomy, is a modern endoscopic technique used to treat gastroparesis.
Gastroparesis is a condition in which the stomach does not empty properly due to impaired stomach movement.
Symptoms of Gastroparesis
Common symptoms may include:
- Persistent vomiting.
- A constant feeling of fullness.
- Inability to finish a medium-sized meal.
- Early satiety after eating small amounts of food.
Gastroparesis is commonly diagnosed using a gastric emptying study.
How G-POEM Works
G-POEM is performed using an upper GI endoscope. The procedure involves cutting the pyloric muscle, which is the muscle at the outlet of the stomach leading to the duodenum, to help improve stomach emptying.
Z-POEM for Zenker’s Diverticulum
Zenker’s diverticulum usually begins with difficulty swallowing without any visible external swelling.
Over time, the pouch gradually enlarges in the area between the pharynx and the esophagus. This can put pressure on the pharyngeal wall and lead to swallowing difficulties and other symptoms.
Symptoms of Zenker’s Diverticulum
Common symptoms may include:
- Difficulty swallowing.
- Regurgitation of food.
- Persistent coughing, especially at night.
- Bad breath due to food retention inside the pouch.
- Hoarseness or voice changes.
- Weight loss and general weakness.
- A sensation of a lump in the neck.
If left untreated, symptoms may worsen and lead to serious complications.
How Z-POEM Works
Z-POEM is an advanced endoscopic procedure used to treat Zenker’s diverticulum without traditional surgery. It is performed through the mouth using an endoscope to divide the septum of the pouch and improve swallowing.
ESD, STER and EFTR for Gastrointestinal Tumors
Not all gastrointestinal tumors require traditional surgery.
Some superficial tumors in the digestive tract can be removed endoscopically through the mouth or rectum using advanced techniques such as ESD, STER, and EFTR.
ESD — Endoscopic Submucosal Dissection
ESD is used to remove selected superficial tumors from the gastrointestinal tract in one piece. This technique allows precise removal of lesions from the esophagus, stomach, colon, or rectum while preserving the organ.
STER — Submucosal Tunneling Endoscopic Resection
STER is used for selected tumors that arise beneath the mucosal layer of the digestive tract. The procedure involves creating a tunnel inside the wall of the gastrointestinal tract to safely reach and remove the tumor.
EFTR — Endoscopic Full-Thickness Resection
EFTR is used in selected cases where the lesion is fibrotic or involves deeper layers of the gastrointestinal wall. It allows full-thickness removal of certain lesions endoscopically, depending on the case and medical evaluation.
Why Third Space Endoscopy Is Important
Third Space Endoscopy provides advanced minimally invasive solutions for complex gastrointestinal conditions. It can help treat swallowing disorders, gastroparesis, Zenker’s diverticulum, and selected gastrointestinal tumors with less trauma, faster recovery, and without open surgery in many cases.
