Last June in Humanitas there was a course dedicated to the trans-oral endoscopic myotomy (POEM), a minimally invasive procedure, useful in the treatment of achalasia and disorders of esophageal motility.

The course is directed by Professor Alessandro Repici, Head of Digestive Endoscopy at Humanitas, Dr. Roberta Maselli, Specialist in Digestive Endoscopy at Humanitas, Professor Haruhiro Inoue (Yokohama – Japan) and Professor Pankaj Jay Pasricha (Baltimore – USA).

Professor Haruhiro Inoue himself, the first to perform endoscopic myotomy on patients, gave an interview to Humanitas, recounting how this approach was born and offering his insight into the future of endoscopy.


Why did you decide to take an interest in endoscopy?

“I started my career as a surgeon, and I still am, but since we treat gastrointestinal tract pathologies through a luminous flux tube, in surgery the outer part of the tube is analyzed, while in digestive endoscopy the analysis of the tract is performed from inside the tube.

We definitely need both approaches because using one of them individually would be a limitation.


How did the use of POEM come about?

“My first POEM case dates back to 2008, when I had previously operated on patients with achalasia through laparoscopy. When I read an article explaining the POEM technique on animals, I understood that it could also be done on humans, so immediately after obtaining approval to proceed we did the first operation.


Do you have any doubts that POEM could replace surgery?

“POEM operates in a submucosal space, thus creating a third space that allows us to directly reach the muscle layer, so as to better treat the pathology of the gastrointestinal tract.


In your opinion, who between the gastroenterologist and the surgeon can perform the best surgery?

“Endoscopy as a therapy is becoming increasingly invasive. I would say that both are important: the gastroenterologist because he knows the anatomy well and the surgeon because he controls flexible endoscopy very well.


What do you think about the future and progress of endoscopy?

“As for the future of endoscopy combined with other technologies, genetic therapies or other advances in medicine, it has unlimited possibilities to evolve.


Check out the full interview here: