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POEM using HybridKnife®

  • Esophageal motility disorders
  • Achalasia
  • Dysphagia
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Leaflet

POEM with HybridKnife 305,93 KB EN
HybridKnife 634,34 KB EN
ERBEJET 2 634,09 KB EN

Operation steps

  • Elevation
    Elevation

    The mucosa is lifted above the initial esophageal stenosis at the 2 o’clock position3 (alternative: 5 o’clock). As a result of the high-pressurewaterjet elevation, layer-specific accumulation of the separation medium occurs beneath the mucosa, creating a submucosal cushion.

  • Incision / Dissection
    Incision / Dissection

    Using the electrosurgical function of the HybridKnife, the mucosa is opened to a length of approximately 2 cm(3) at around 5 cm above the stenosis.

  • Preparation
    Preparation

    While alternating between the waterjet and the electrosurgical function of the HybridKnife, a submucosal tunnel is created. Thanks to the high-pressure waterjet, a protective layer is established to the mucosa which protects it from mechanical and thermal damage. The tunnel is prepared to approximately 2 cm below the gastroesophageal junction.

  • Myotomy
    Myotomy

    Using the HybridKnife, a myotomy is then performed of the sphincter, beginning at around 3 cm below the location of the incision up to approximately 2 cm beneath the gastroesophageal junction. Possible bleeding can be immediately coagulated using the HybridKnife. Following the myotomy, the cut is covered using the intact mucosa and the incision location closed using clips.