Thoracic surgeons Dennis Wigle, M.D., Ph.D. , and Shanda Blackmon, M.D., M.P.H., speak to how Mayo Clinic’s highly skilled experts are treating achalasia by using innovative, minimally invasive techniques to improve patient outcomes.
Michael asia overall is a very rare disorder that happens in less than one in 100,000 people in the population. And basically it's a disorder of the innovation of the esophagus such that the esophagus doesn't squeeze properly and push contents down when people actually swallow. And it's also a failure of the relaxation of the lower esophageal sphincter to allow contents to move from the esophagus into the stomach. Patients with a cal asia frequently suffer from chronic regurgitation of food dysplasia from problems swallowing and weight loss. Patients who have ankle asia frequently are very difficult to discriminate between patients who might have cancer at the lower part of the esophagus versus patients who have other problems with esophageal motility. It's not really first in mind when someone presents with those symptoms. So sometimes it can take more work or more detailed testing in order to even recognize that maybe what someone's experiencing is not some of the other routine disorders we see in the esophagus and someone really gets a hint that this might be something like Akhil Asia in our clinic. We have access to some of the latest equipment and utility to working out patients with Akhil Asia. We have endo flip, which is a balloon that goes inside the esophagus and measures the pressure within the esophagus to measure efficacy of treatment and measure and diagnosed tackle asia correctly. We're constantly on the lookout for trying to figure out how do we um provide the best pal e ation we can in the most minimally invasive way possible. And that's really where the rapid adoption of the poem procedure comes in to try and be able to do something similar to what already has a long history for. Hello my ah to me and do that completely incision list through an endoscopic approach. A modified Hello my Autumn E. Is most frequently done with a laparoscopic approach And that means small ports in the abdomen, minimally invasive cutting that muscle for about 9-10 cm, extending the cut down onto the stomach. Unfortunately after that muscle gets cut, patients have about a 25% chance of having pretty bad reflux that can result in esophagitis. And so the surgical approach is sometimes preferred for patients who really don't want to have reflux after the procedure. And the procedure can be followed by a lab risk opic fund application and that's a partial wrap either on the front of the esophagus or the back of the esophagus. And that wrap is intended to prevent reflux. And then the other treatments that we use like balloon dilation and Botox injection. They don't have a durable effect. But the approach is the same to try and open up that lower esophageal sphincter and keep it open. The multidisciplinary Akhil Asia clinic is comprised of a bunch of different providers here at Mayo clinic. All of these teams work together to make sure that the patients get the best diagnosis intervention and postoperative care anywhere along the treatment paradigm right from diagnosis through the treatment and even follow up from there. Really, at any point that would be appropriate to have a patient referred to us. I hope that providers can trust Mayo clinic to be there and help them get their patients the right diagnosis, the right treatment, the right intervention, and deliver the patient back to them mm.
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