Having surgery

POEM surgery can help your symptoms and improve swallowing by allowing the oesophagus to empty. 

We cut the lower oesophageal sphincter muscle fibres. This muscle separates the oesophagus from the stomach and acts like a valve to stop food and drink from backing up (reflux).

You have POEM surgery under general anaesthetic.

You are likely to stay in hospital for 1 or 2 nights.

Pre-assessment

You attend a pre-assessment appointment in the outpatient clinic.

It's important that you are on a liquid-only diet for 3 days before surgery to make sure that your food pipe is empty. 

The surgeon may still want to do a gastroscopy and wash out your oesophagus on the day of surgery. 

During surgery

Surgery is done under general anaesthetic and takes about 2 hours.

We pass a thin, flexible tube (endoscope) through your mouth.

We make a small cut in the lining of the oesophagus. We carefully divide the lower oesophageal sphincter muscle fibres. The cut is then closed.

The surgery is done inside the oesophagus so you will not have a visible cut (incision) or wound. 

After surgery

You stay in the recovery room until you are comfortable and fully awake. 

Carbon dioxide gas is used during surgery to inflate the oesophagus. This means you might feel bloated or feel pain in your chest, neck and tummy. The carbon dioxide and any pain will be gone within a few hours. 

We give you painkillers during and after surgery but let us know if you are uncomfortable.

We move you to a hospital bed where we regularly check your pulse, blood pressure, temperature and breathing. 

We encourage you to drink sips of water and to get out of bed and move about. 

The next day, you have an X-ray to check that your incision is sealed. If we are satisfied with the X-ray results, you will be able to drink tea or other beverages. 

You  usually stay in hospital for 1 or 2 nights. However, if there are any complications you will need to stay in hospital until these have been resolved. 

Recovery

We ask you to follow a free-fluid diet for the first week. After that you can start eating normal food again.

We give you painkillers when you are discharged from hospital. It is unlikely that you will need strong painkillers after 1 to 2 days.

You should take 2 weeks off work to recover. If you are well at this point, you can go back to all your normal activities.  

Follow-up appointment

We make a follow-up appointment with the surgeon or clinical nurse specialist for about 6 weeks after you were discharged.

At this appointment, we check if the surgery has been successful and if any reflux symptoms have developed. If surgery has not improved your swallowing, we can talk about if other treatments options might help you. 

There are no stitches to be removed.