Modified peroral endoscopic myotomy: a "Push and Pull" technique.

Background: Peroral endoscopic myotomy (POEM) is a minimally invasive yet challenging procedure for achalasia. Additional technological innovations and improvements are important for simplifying the procedure.

Methods: We report the successful use of a modified POEM procedure, which utilized a "Push and Pull" technique, on a patient with achalasia.

Results: Our modifications resulted in a short operation time of only 35 min. No complications arose during or after the procedure, up to a follow-up period of 6 months, and symptoms were significantly and quickly improved.

Conclusions: This modified procedure shortens operation time and lowers the difficulty of the operation, while leaving the safety and efficacy uncompromised.