Is EndoFLIP™ Helpful in Individualizing G-POEM for Delayed Gastric Emptying After Esophagectomy

Delayed gastric emptying complicates recovery in 10–50% of patients after esophagectomy. Available therapies now include peroral endoscopic myotomy (POEM) applied to the pylorus (G-POEM). Selection of patients for this procedure is not always straightforward. A newer instrument (functional luminal imaging probe; EndoFLIP™) assesses sphincter contour and distensibility using endoscopic impedance planimetry. Whether this technology can help select patients for G-POEM and assist in determining completeness of G-POEM intervention is reviewed in this chapter. We found that EndoFLIP™ can help individualize the management of delayed gastric emptying after esophagectomy. Use of EndoFLIP™ is recommended to assess the pylorus in patients with suspected delayed gastric emptying. The use of EndoFLIP™ during G-POEM is recommended to assess completeness of pyloromytomy and help ensure post-procedure symptom improvement.