Per-oral endoscopic myotomy for achalasia: An American perspective

Table 1 Per-oral endoscopic myotomy equipment

High-definition diagnostic gastroscope

Transparent 4 mm distal cap attachment

Electrosurgical device for injection of saline, incision and cautery ( T-type HK hybrid knife- with Erbe jet pump)

Electrosurgical device for incision and cautery (Triangle tip knife) and injection of saline with Injector force Max 4 mm, 23-gauge injection needle

Electrosurgical high frequency generator (e.g., ERBE VIO 300D)

Coagulation 5 mm grasper (Olympus)

Endoscopic clips (Boston-Scientific, Olympus, Wilson-Cook)

Needle or trocar for potential decompression of capnoperitoneum (angiocatheter, Veress needle 120 mm)

Endoscopic dilating balloons- CRE balloon dilator (5.5 cm, 10-11-12 mm) multiple manufacturers (rarely required)

Submucosal injection: Methylene blue or indigo carmine diluted in saline

CRE: Controlled radial expansion.