Starting a peroral endoscopic myotomy program at your institution

Author Department

Medicine; Surgery

Document Type

Article, Peer-reviewed

Publication Date



Starting a peroral endoscopic myotomy (POEM) program can be difficult. There is no substitute for careful planning and execution. Support at every level is required to make a POEM program a reality. There are 5 essential components to start a POEM program: recruiting collaborators, proper clinical training, institutional support, institutional review board approval, and technical/engineering/nursing support. Without these key components, any endeavor to set up a POEM program is less likely to be successful. Having a collaborative, multidisciplinary team is important for success. Adequate preparation and training are a must. To that end, observation of live human cases and hands-on experience in the animal laboratory are essential prerequisites. Institutional support in terms of laboratory funding, protected time for research, billing and coding assistance, and endorsement of one's Credentialing Committee are also significant components of a successful program. At least initially, a POEM program should be executed under the oversight of one's institutional review board to legitimize the program for medicolegal purposes, and to help smooth the credentialing process. Finally, support from key personnel should be obtained. These include surgical and endoscopy nurses and technicians, recovery room and ward nurses, and also endoscopy and device representatives, all of whom can provide vital technical assistance when and where it is needed most.