Clinical outcomes and safety of high-resolution manometry guided superficial partial circular muscle myotomy in per-oral endoscopic myotomy for Jackhammer esophagus: Two cases report

Figure 3 Procedures of high-resolution manometry guided superficial partial circular muscle myotomy. A: We first detect the hypercontractile lesion through high-resolution manometry (HRM), and in this patients’ case, HRM showed high-amplitude distal esophageal contractions located 25-38 cm from the incisors according to the distance gauge of the pressure measuring tubes. B: Therefore, we performed superficial partial circular muscle myotomy of the esophageal muscle on the right side, (B) Superficial partial circular muscle myotomy during POEM. Remnant circular muscle.