Anybody has a redo-POEM done? Or get suggested?
As I read it, the surgery is being repeated? Is this because it did not go according to plan; or is it a question of not having cut the muscles over sufficient length to release tension in the lower oesophageal sphincter; or for some other reason? That might determine where you have it done, or whom you consult for a potential second opinion.
Potentially, the POEM surgery might be revised with orthodox procedures, but it would be a very specialised field where experience will count for a great deal.
Thanks Alen for your reply. My daughter had the POEM in Oct but it didn’t help, the regur continued and she lost weight again. The surgeon was a pediatric POEM surgeon and highly regarded in his field but since the childhood A is rare, he has only done 14-15 POEM in last 3 years. So in my daughter ‘a case, it seems the muscle was not cut enough, unfortunately. He used endoflip to measure, and told us that all the measurements look good but maybe because of endoflip, he was overly causious for not cutting too much. He’s suggessting a HM but they haven’t done HM for the last 3-4 years so we’re not comfortable for taking that offer. My daughter would like to go with another POEM if possible, so we’re in the process of talking to doctors for that. I was just wondering anybody in the group has any experience or suggestions.
Alan, sorry, not Alen.
I can understand the surgeon being cautious, which is understandable.
I imagine that repeating the manometry and barium swallow tests would give a good indication of where the issues are occurring most recently, and how these relate to the area that was subject to the POEM procedure.
Has your daughter suffered any reflux since the operation? One advantage of the Heller's myotomy is that it does seek to re-create the valve effect on the lower oesophageal sphincter. Another surgeon would indeed have to do this who had recent experience.
I suppose it all depends on how the surgeon regards the prognosis for a repeat / revision POEM.