{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:06:39Z","timestamp":1773399999987,"version":"3.50.1"},"reference-count":74,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Main Recommendations<\/jats:title><jats:p>Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure that has become a first-line treatment for esophageal achalasia and other esophageal spastic disorders. Structured training is essential to optimize the outcomes of this technique. The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in POEM. This Position Statement presents the results of a systematic review of the literature and a formal Delphi process, providing recommendations for an optimal training program in POEM that aims to produce endoscopists competent in this procedure. In a separate document (POEM curriculum Part II), we provide technical guidance on how to perform the POEM procedure based on the best available evidence.<\/jats:p><jats:p>\n               1 POEM trainees should acquire a comprehensive theoretical knowledge of achalasia and other esophageal motility disorders that encompasses pathophysiology, diagnostic tool proficiency, clinical outcome assessment, potential adverse events, and periprocedural management.<\/jats:p><jats:p>\n               2 Experience in advanced endoscopic procedures (endoscopic mucosal resection and\/or endoscopic submucosal dissection [ESD]) is encouraged as a beneficial prerequisite for POEM training.<\/jats:p><jats:p>\n               3 ESGE suggests that POEM trainees without ESD experience should perform an indicative minimum number of 20 cases on ex vivo or animal models before advancing to human POEM cases with an experienced trainer.<\/jats:p><jats:p>\n               4 ESGE recommends that the trainee should observe an indicative minimum number of 20 live cases at expert centers before starting to perform POEM in humans.<\/jats:p><jats:p>\n               5 The trainee should undertake an indicative minimum number of 10 cases under expert supervision for the initial human POEM procedures, ensuring that trainees can complete all POEM steps independently.<\/jats:p><jats:p>\n               6 ESGE recommends avoiding complex POEM cases during the early training phase. <\/jats:p><jats:p>\n               7 POEM competence should reflect the technical success rate, both the short- and long-term clinical success rates, and the rate of true adverse events.<\/jats:p><jats:p>\n               8 A POEM center should maintain a prospective registry of all procedures performed, including patient work-up and outcomes, procedural techniques, and adverse events.<\/jats:p>","DOI":"10.1055\/a-2568-7473","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T23:01:01Z","timestamp":1744239661000},"page":"778-795","source":"Crossref","is-referenced-by-count":5,"title":["Curriculum for training in peroral endoscopic myotomy (POEM) in Europe (Part I): European Society of Gastrointestinal Endoscopy (ESGE) Position Statement"],"prefix":"10.1055","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2852-6042","authenticated-orcid":false,"given":"Enrique","family":"Rodr\u00edguez de Santiago","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hospital Universitario Ram\u00f3n y Cajal, Madrid, Spain"},{"name":"Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en el \u00c1rea tem\u00e1tica de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), Madrid, Spain"}]},{"given":"David J.","family":"Tate","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium"}]},{"given":"Ian M.","family":"Gralnek","sequence":"first","affiliation":[{"name":"Ellen and Pinchas Mamber Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel"},{"name":"Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3304-0271","authenticated-orcid":false,"given":"Tony C.","family":"Tham","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0614-0576","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Santos-Antunes","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Centro Hospitalar S. Jo\u00e3o, Porto, Portugal"}]},{"given":"Sandra","family":"Nagl","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany"}]},{"given":"Zuzana","family":"Vackov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Endoscopy, Military University Hospital Prague, Prague, Czech Republic"}]},{"given":"Marcel","family":"Tantau","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy \u201cIuliu Hatieganu\u201d, Cluj-Napoca, Romania"}]},{"given":"Isis K.","family":"Araujo","sequence":"additional","affiliation":[{"name":"Endoscopy and Motility Unit, Gastroenterology Department, Hospital Clinic de Barcelona, Barcelona, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8023-3722","authenticated-orcid":false,"given":"Eduardo Guimar\u00e3es Hourneaux","family":"de Moura","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Hospital das Cl\u00ednicas of the University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}]},{"given":"Pietro","family":"Familiari","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}]},{"given":"Helmut","family":"Messmann","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany"}]},{"given":"Alanna","family":"Ebigbo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany"}]},{"given":"Paul","family":"Fockens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The Netherlands"},{"name":"Waikato Hospital, Hamilton, New Zealand"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9994-8226","authenticated-orcid":false,"given":"Raf","family":"Bisschops","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium"},{"name":"Department of Translational Research in Gastrointestinal Diseases (TARGID), KU Leuven, Leuven, Belgium"}]},{"given":"Henriette","family":"Heinrich","sequence":"additional","affiliation":[{"name":"Clarunis, Universit\u00e4res Bauchzentrum, Basel, Switzerland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9311-3746","authenticated-orcid":false,"given":"Eduardo","family":"Alb\u00e9niz","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario de Navarra, Navarrabiomed, UPNA, IdiSNA, Pamplona, Spain"}]},{"given":"Amrita","family":"Sethi","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy Services, Division of Digestive and Liver Disease, Columbia University Irving Medical Center, New York, New York, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0212-1549","authenticated-orcid":false,"given":"Oleksandr","family":"Kiosov","sequence":"additional","affiliation":[{"name":"University Clinic, Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1415-4719","authenticated-orcid":false,"given":"Jan","family":"Martinek","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St. Anne University Hospital, Brno, Czech Republic"}]},{"given":"Roy","family":"Soetikno","sequence":"additional","affiliation":[{"name":"Clinical Medicine, University of California San Francisco, California, USA"}]}],"member":"194","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1038\/ajg.2013.196","article-title":"ACG clinical guideline: diagnosis and management of achalasia","volume":"108","author":"M F Vaezi","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e256","DOI":"10.1111\/j.1365-2982.2010.01511.x","article-title":"Achalasia: incidence, prevalence and survival. A population-based study","volume":"22","author":"D C Sadowski","year":"2010","journal-title":"Neurogastroenterol Motil"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/S0140-6736(13)60651-0","article-title":"Achalasia","volume":"383","author":"G E Boeckxstaens","year":"2014","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1177\/2050640620903213","article-title":"European Guideline on Achalasia \u2013 UEG and ESNM recommendations","volume":"8","author":"R Oude Nijhuis","year":"2020","journal-title":"United European Gastroenterol J"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1055\/a-1160-5549","article-title":"Endoscopic management of gastrointestinal motility disorders \u2013 part 1: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"52","author":"B LAM Weusten","year":"2020","journal-title":"Endoscopy"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1055\/a-1000-5603","article-title":"European Society of Gastrointestinal Endoscopy (ESGE) curricula development for postgraduate training in advanced endoscopic procedures: rationale and methodology","volume":"51","author":"R Bisschops","year":"2019","journal-title":"Endoscopy"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1055\/a-1067-4657","article-title":"European Society of Gastrointestinal Endoscopy (ESGE) Publications Policy \u2013 Update 2020","volume":"52","author":"C Hassan","year":"2020","journal-title":"Endoscopy"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1136\/bmjebm-2022-111962","article-title":"Good or best practice statements: proposal for the operationalisation and implementation of GRADE guidance","volume":"28","author":"O Dewidar","year":"2023","journal-title":"BMJ Evid Based Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1055\/a-1171-3174","article-title":"Endoscopic management of gastrointestinal motility disorders \u2013 part 2: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"52","author":"B LAM Weusten","year":"2020","journal-title":"Endoscopy"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.gie.2012.10.017","article-title":"Thoughts on starting a peroral endoscopic myotomy program","volume":"77","author":"M A Khashab","year":"2013","journal-title":"Gastrointest Endosc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.1007\/s00464-017-5823-3","article-title":"Teaching peroral endoscopic myotomy (POEM) to surgeons in practice: an \u201cinto the fire\u201d pre\/post-test curriculum","volume":"32","author":"T Kishiki","year":"2018","journal-title":"Surg Endosc"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.giec.2015.12.009","article-title":"New NOTES clinical training and program development","volume":"26","author":"P Saxena","year":"2016","journal-title":"Gastrointest Endosc Clin N Am"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"E1826","DOI":"10.1055\/a-1264-7542","article-title":"Per-oral endoscopic myotomy (POEM) training and skills evaluation tool: a pilot study","volume":"8","author":"A Schlachterman","year":"2020","journal-title":"Endosc Int Open"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"36","DOI":"10.18528\/ijgii200002","article-title":"Establishing a submucosal endoscopy program in a gastrointestinal unit. raining for peroral endoscopic myotomy","volume":"9","author":"P Varma","year":"2020","journal-title":"Int J Gastrointest Interv"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1053\/j.gastro.2017.11.293","article-title":"Advances and challenges in endoscopic training","volume":"154","author":"K A Waschke","year":"2018","journal-title":"Gastroenterology"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1016\/j.surg.2020.08.023","article-title":"Teaching peroral endoscopic pyloromyotomy (POP) to practicing endoscopists: An \u201cinto-the-fire\u201d approach to simulation","volume":"169","author":"H J Wong","year":"2021","journal-title":"Surgery"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.tgie.2013.05.001","article-title":"Training for peroral endoscopic myotomy","volume":"15","author":"D von Renteln","year":"2013","journal-title":"Techniques in Gastrointestinal Endoscopy"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.gie.2020.10.026","article-title":"Core curriculum for peroral endoscopic myotomy (POEM)","volume":"93","author":"S Dacha","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"17507","DOI":"10.3748\/wjg.v20.i46.17507","article-title":"Endoscopic non-technical skills team training: the next step in quality assurance of endoscopy training","volume":"20","author":"M Matharoo","year":"2014","journal-title":"World J Gastroenterol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1136\/flgastro-2016-100800","article-title":"Non-technical skills and gastrointestinal endoscopy: a review of the literature","volume":"9","author":"C R Hitchins","year":"2018","journal-title":"Frontline Gastroenterol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1136\/flgastro-2020-101561","article-title":"Improving safety and reducing error in endoscopy (ISREE): a survey of UK services","volume":"12","author":"S Ravindran","year":"2021","journal-title":"Frontline Gastroenterol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"234","DOI":"10.14309\/ajg.0000000000000426","article-title":"Colonoscopy Direct Observation of Procedural Skills assessment tool for evaluating competency development during training","volume":"115","author":"K Siau","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.14309\/ajg.0000000000000671","article-title":"Do nontechnical skills affect legal outcomes after endoscopic perforations?","volume":"115","author":"L V Hernandez","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"468","DOI":"10.4253\/wjge.v5.i10.468","article-title":"How we can measure quality in colonoscopy?","volume":"5","author":"L A Bourikas","year":"2013","journal-title":"World J Gastrointest Endosc"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1111\/den.13623","article-title":"Non-technical skills curriculum incorporating simulation-based training improves performance in colonoscopy among novice endoscopists: Randomized controlled trial","volume":"32","author":"C M Walsh","year":"2020","journal-title":"Dig Endosc"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"E931","DOI":"10.1055\/s-0043-113561","article-title":"Factors defining expertise in screening colonoscopy","volume":"5","author":"K Patel","year":"2017","journal-title":"Endosc Int Open"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1016\/j.gie.2015.04.008","article-title":"Impact of a simulation training curriculum on technical and nontechnical skills in colonoscopy: a randomized trial","volume":"82","author":"S C Grover","year":"2015","journal-title":"Gastrointest Endosc"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1136\/bmjstel-2019-000526","article-title":"Development and impact of an endoscopic non-technical skills (ENTS) behavioural marker system","volume":"7","author":"S Ravindran","year":"2020","journal-title":"BMJ Simul Technol Enhanc Learn"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1055\/a-1832-4232","article-title":"Performance measures for the SACRED team-centered approach to advanced gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative","volume":"54","author":"H-L Ching","year":"2022","journal-title":"Endoscopy"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1055\/a-2077-0497","article-title":"Curriculum for training in endoscopic mucosal resection in the colon: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement","volume":"55","author":"D J Tate","year":"2023","journal-title":"Endoscopy"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1055\/a-0991-0044","article-title":"ERCP assessment tool: evidence of validity and competency development during training","volume":"51","author":"K Siau","year":"2019","journal-title":"Endoscopy"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"E268","DOI":"10.1055\/a-2017-3827","article-title":"Who will excel in advanced endoscopy? A study assessing the criteria and perceptions of experts with regard to selection of ERCP and EUS trainees","volume":"11","author":"S Campos","year":"2023","journal-title":"Endosc Int Open"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"E1890","DOI":"10.1055\/a-1610-8962","article-title":"Pilot prospective study on formal training in per-oral endoscopic myotomy (POEM) during advanced endoscopy fellowship","volume":"9","author":"S Jawaid","year":"2021","journal-title":"Endosc Int Open"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1016\/j.gie.2012.12.006","article-title":"Peroral endoscopic esophageal myotomy: defining the learning curve","volume":"77","author":"A A Kurian","year":"2013","journal-title":"Gastrointest Endosc"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.gie.2023.07.032","article-title":"Development and initial validation of a video-based peroral endoscopic myotomy assessment tool","volume":"99","author":"D Yang","year":"2024","journal-title":"Gastrointest Endosc"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1055\/a-1935-1093","article-title":"Learning curve for esophageal peroral endoscopic myotomy: a systematic review and meta-analysis","volume":"55","author":"S R Puli","year":"2023","journal-title":"Endoscopy"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1111\/den.14435","article-title":"Learning curve for peroral endoscopic myotomy in therapeutic endoscopy experts and nonexperts: Large single-center experience","volume":"35","author":"Y Fujiyoshi","year":"2023","journal-title":"Dig Endosc"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"512","DOI":"10.4253\/wjge.v14.i9.512","article-title":"Simulation-based mastery learning in gastrointestinal endoscopy training","volume":"14","author":"H Maulahela","year":"2022","journal-title":"World J Gastrointest Endosc"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.tgie.2017.09.002","article-title":"Training pathways and competency assessment in peroral endoscopic myotomy (POEM)","volume":"19","author":"C Mittal","year":"2017","journal-title":"Tech Gastrointest Endosc"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5946\/ce.2022.191","article-title":"Simulator-based training method in gastrointestinal endoscopy training and currently available simulators","volume":"56","author":"Y Kim","year":"2023","journal-title":"Clin Endosc"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.gie.2018.10.037","article-title":"Endoscopic simulators","volume":"90","author":"A J Goodman","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1007\/s00464-003-9143-4","article-title":"The learning curve for a colonoscopy simulator in the absence of any feedback: no feedback, no learning","volume":"18","author":"T Mahmood","year":"2004","journal-title":"Surg Endosc"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"AB152","DOI":"10.1016\/j.gie.2017.03.324","article-title":"Feasibility of EndogelTM simulation training for per-oral endoscopic myotomy (POEM): First United Kingdom experience","volume":"85","author":"S Gulati","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.giec.2015.12.007","article-title":"Pre-clinical training for new notes procedures: from ex-vivo models to virtual reality simulators","volume":"26","author":"M A Gromski","year":"2016","journal-title":"Gastrointest Endosc Clin N Am"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"329","DOI":"10.2147\/TCRM.S32666","article-title":"Training in peroral endoscopic myotomy (POEM) for esophageal achalasia","volume":"8","author":"N Eleftheriadis","year":"2012","journal-title":"Ther Clin Risk Manag"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1055\/s-0033-1344153","article-title":"Animal models for endoscopic training: do we really need them?","volume":"45","author":"A Parra-Blanco","year":"2013","journal-title":"Endoscopy"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"952","DOI":"10.3109\/00365521.2014.983152","article-title":"A stepwise approach for peroral endoscopic myotomy for treating achalasia: from animal models to patients","volume":"50","author":"Y Ren","year":"2015","journal-title":"Scand J Gastroenterol"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.gie.2012.08.018","article-title":"Peroral endoscopic myotomy for treatment of achalasia: from bench to bedside (with video)","volume":"77","author":"P WY Chiu","year":"2013","journal-title":"Gastrointest Endosc"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"339","DOI":"10.17235\/reed.2020.7116\/2020","article-title":"Implementation of a peroral endoscopic myotomy program","volume":"113","author":"P Miranda-Garc\u00eda","year":"2021","journal-title":"Rev Esp Enferm Dig"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"2062","DOI":"10.1007\/s00464-022-09736-3","article-title":"Training in esophageal peroral endoscopic myotomy (POEM) on an ex vivo porcine model: learning curve study and training strategy","volume":"37","author":"J-M Gonzalez","year":"2023","journal-title":"Surg Endosc"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.rgmx.2017.04.003","article-title":"In vivo experience with peroral endoscopic myotomy: An essential activity for developing the technique in humans","volume":"83","author":"A Pe\u00f1aloza-Ram\u00edrez","year":"2018","journal-title":"Rev Gastroenterol Mex (Engl Ed)"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"E559","DOI":"10.1055\/s-0034-1392807","article-title":"The per oral endoscopic myotomy (POEM) technique: how many preclinical procedures are needed to master it?","volume":"3","author":"O V Hern\u00e1ndez Mondrag\u00f3n","year":"2015","journal-title":"Endosc Int Open"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1177\/2050640617742484","article-title":"Training in endoscopic mucosal resection and endoscopic submucosal dissection: Face, content and expert validity of the live porcine model","volume":"6","author":"R K\u00fcttner-Magalh\u00e3es","year":"2018","journal-title":"United European Gastroenterol J"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"2895","DOI":"10.3748\/wjg.v16.i23.2895","article-title":"Endoscopic submucosal dissection training with pig models in a Western country","volume":"16","author":"A Parra-Blanco","year":"2010","journal-title":"World J Gastroenterol"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"546","DOI":"10.4321\/s1130-01082009000800005","article-title":"Training model for teaching endoscopic submucosal dissection of gastric tumors","volume":"101","author":"E V\u00e1zquez-Sequeiros","year":"2009","journal-title":"Rev Esp Enferm Dig"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1177\/2050640618788694","article-title":"Efficacy of a three-day training course in endoscopic submucosal dissection using a live porcine model: a prospective evaluation","volume":"6","author":"N Chapelle","year":"2018","journal-title":"United European Gastroenterol J"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"4774","DOI":"10.1007\/s00464-023-09940-9","article-title":"Endoscopic submucosal dissection training: evaluation of an ex vivo training model with continuous perfusion (ETM-CP) for hands-on teaching and training in China","volume":"37","author":"J Huang","year":"2023","journal-title":"Surg Endosc"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"2276","DOI":"10.1007\/s10620-023-07839-y","article-title":"Successful design and implementation of a POEM program for achalasia in an integrated healthcare system","volume":"68","author":"L J Leung","year":"2023","journal-title":"Dig Dis Sci"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1016\/j.gie.2014.10.002","article-title":"The light at the end of the tunnel: a single-operator learning curve analysis for per oral endoscopic myotomy","volume":"81","author":"K S Patel","year":"2015","journal-title":"Gastrointest Endosc"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1420","DOI":"10.1016\/j.cgh.2017.11.048","article-title":"Comprehensive evaluation of the learning curve for peroral endoscopic myotomy","volume":"16","author":"Z Liu","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"E577","DOI":"10.1055\/s-0042-104113","article-title":"Learning curve for peroral endoscopic myotomy","volume":"4","author":"M El Zein","year":"2016","journal-title":"Endosc Int Open"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1111\/den.12763","article-title":"Analysis of the learning curve for peroral endoscopic myotomy for esophageal achalasia: Single-center, two-operator experience","volume":"29","author":"H Lv","year":"2017","journal-title":"Dig Endosc"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1007\/s11605-013-2332-0","article-title":"Analysis of a learning curve and predictors of intraoperative difficulty for peroral esophageal myotomy (POEM)","volume":"18","author":"E N Teitelbaum","year":"2014","journal-title":"J Gastrointest Surg"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"3046","DOI":"10.1007\/s00464-017-6015-x","article-title":"Outcomes and quality of life assessment after per oral endoscopic myotomy (POEM) performed in the endoscopy unit with trainees","volume":"32","author":"S Dacha","year":"2018","journal-title":"Surg Endosc"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1097\/SLE.0000000000001014","article-title":"Long-term outcome of per-oral endoscopic myotomy performed in the endoscopy unit with trainees","volume":"32","author":"M M Abdelfatah","year":"2021","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"625","DOI":"10.5946\/ce.2021.217","article-title":"Issues to be considered for learning curve for peroral endoscopic myotomy","volume":"54","author":"H Shiwaku","year":"2021","journal-title":"Clin Endosc"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1111\/den.13294","article-title":"Peroral endoscopic myotomy (POEM) for complex achalasia and the POEM difficulty score","volume":"31","author":"R Bechara","year":"2019","journal-title":"Dig Endosc"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"2781","DOI":"10.1007\/s00464-022-09798-3","article-title":"A prediction model and nomogram for technical difficulty of peroral endoscopic myotomy","volume":"37","author":"X-Y Liu","year":"2023","journal-title":"Surg Endosc"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1111\/den.14508","article-title":"Risk-scoring system for predicting challenging cases of peroral endoscopic myotomy","volume":"35","author":"T Nakai","year":"2023","journal-title":"Dig Endosc"},{"key":"ref70","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1111\/den.13239","article-title":"Clinical practice guidelines for peroral endoscopic myotomy","volume":"30","author":"H Inoue","year":"2018","journal-title":"Dig Endosc"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"701","DOI":"10.5946\/ce.2020.290","article-title":"The learning curve for peroral endoscopic myotomy in Latin America: a slide to the right?","volume":"54","author":"M Kahaleh","year":"2021","journal-title":"Clin Endosc"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"323","DOI":"10.15403\/jgld-2676","article-title":"POEM: Five years of experience in a single East European center","volume":"29","author":"C Tefas","year":"2020","journal-title":"J Gastrointest Liver Dis"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"138","DOI":"10.4103\/1357-6283.170124","article-title":"Application of Kern\u2019s Six-step approach to curriculum development by global health residents","volume":"28","author":"L R Sweet","year":"2015","journal-title":"Educ Health (Abingdon)"},{"key":"ref74","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1055\/s-0031-1291747","article-title":"European Society of Gastrointestinal Endoscopy (ESGE) Guideline Development Policy","volume":"44","author":"J M Dumonceau","year":"2012","journal-title":"Endoscopy"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2568-7473.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T22:31:03Z","timestamp":1751063463000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2568-7473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,9]]},"references-count":74,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2025,6,27]]},"published-print":{"date-parts":[[2025,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2568-7473","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,9]]}}}