Endoscopic pyloromyotomy via a gastric submucosal tunnel dissection for the treatment of gastroparesis after surgical vagal lesion

摘要

Since 2011, we have been developing the technique of pyloromyotomy via a submucosal tunnel. After establishing the technical feasibility and safety in animal studies, we performed it in a 38-year-old woman who had undergone a gastric fundoplication to treat a hiatal hernia. After that, symptoms of gastroparesis developed. The diagnosis of gastroparesis was confirmed by upper endoscopy, which showed gastric food stasis, and by scintigraphy, which showed gastric emptying delay for solids after 4 hours.