G-POEM, A Minimally Invasive Endoscopic Technique for Gastroparesis

Gastric peroral endoscopic myotomy (G-POEM) is a minimally invasive endoscopic technique introduced to treat refractory gastroparesis, a chronic, debilitating, and difficult to treat condition. The G-POEM procedure was first described in 2013, after which multiple studies followed, reporting G-POEM techniques with slight inter-technique variations. In essence, the G-POEM technique consists of four technical steps: the establishment of a submucosal tunnel in the gastric antrum, identification of the pyloric muscular ring, myotomy of the muscular ring, and closure of the entrance of the submucosal tunnel. G-POEM seems to be a promising endoscopic therapy for patients suffering from refractory gastroparesis, with reported success rates ranging from 80% to 90%. However, it is important to realize that there is still need for further research to determine the value of this minimally invasive technique. Thus, controlled prospective and preferably randomized studies should be conducted with a long follow-up time to determine the actual benefits of the G-POEM procedure.