Per-oral endoscopic myotomy: Major advance in achalasia treatment and in endoscopic surgery

Figure 4 EndoFLIP Images before and after per-oral endoscopic myotomy. Seventy-seven years old man with achalasia for 4 years, prior Botox × 1, esophageal diameter of 5 cm, non-sigmoid, underwent per-oral endoscopic myotomy (POEM), 8 cm posterior myotomy. A: EndoFLIP performed immediately prior to POEM; B: immediately after POEM at 30 mL balloon volume shows an excellent response with increase of the minimal diameter at the gastroesophageal junction (GEJ) (Dmin) from 6.7 to 12.3 cm and increase in cross-sectional diameter at the GEJ (cross-sectional area) from 36 to 119 mm².