POEM Procedure

  POEM Procedure

First in Suffolk County: POEM Procedure Performed by Stony Brook Medicine Physician

This past October, Stony Brook Medicine gastroenterologist Lionel S. D’Souza, MD, performed Suffolk County’s first POEM procedure — a state-of-the-art, incision-free treatment for achalasia. Achalasia is a rare, potentially debilitating swallowing disorder that makes it hard for the food and drink you consume to enter the stomach.

With achalasia, the esophagus and the esophageal sphincter don’t work properly, so food and liquids get “backed up” in the esophagus. The esophagus is the tube that carries what you eat from your mouth to your stomach, and the sphincter is a ring of muscle like a valve that opens to let the food pass into the stomach.

When food sits in the esophagus for long lengths of time, the esophagus lining becomes inflamed and causes symptoms, which vary depending on the severity of the disorder. Symptoms include heartburn, weight loss, nausea, regurgitation, vomiting, chest pain and a low quality of life because eating and drinking are so difficult.

The POEM procedure
POEM (Peroral Endoscopic Myotomy) is a minimally invasive endoscopic procedure that can permanently cure achalasia. There are no incisions on your body — everything is done internally with a thin, flexible tube (endoscope) that goes through your mouth and into the esophagus. A doctor trained in the procedure uses a small knife at the tip of the endoscope to open the passageway so food can travel from your mouth to the stomach.

POEM is the most advanced treatment currently available for achalasia. It’s done with general anesthesia in the Endoscopy Unit or in the operating room. The procedure takes about an hour, and the patient usually goes home the following day. For most patients, POEM has a short recovery time and low risk of bleeding and infection. It is a good alternative to the traditional surgery, called a Heller myotomy, which is a minimally invasive surgery that requires multiple incisions in the abdomen.

The first POEM in Suffolk County
The first patient to receive POEM at Stony Brook Medicine was a 55-year-old male police chief from the East End of Long Island who was having severe symptoms. The patient did extremely well, and is enjoying a much better quality of life since the surgery.

Although this was the first POEM performed in Suffolk County, it was not the first that Dr. D’Souza has completed. Prior to joining Stony Brook, he had extensive training in the POEM technique, and he has successfully performed nearly 50 procedures.

Dr. D’Souza is currently teaming up with Salvatore Docimo Jr., DO, in the Department of Surgery at Stony Brook University School of Medicine to provide these procedures for all patients who need them, and collaborating on cases inside and outside the endoscopy unit. 

“Because POEM requires a high level of technical expertise, very few centers provide this option to patients. We’re happy to now offer this choice to our patients,” said Dr. D’Souza.

To learn more about POEM, call (631) 444-5220.

Photo Caption: Lionel S. D’Souza, MD, prepares for the POEM procedure with the endoscopy team from left, Tin Lynn Win, CRNA; Kelly Van Ness, RN; and Elizabeth DiFrietus, RT