{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:37:32Z","timestamp":1777448252514,"version":"3.51.4"},"reference-count":11,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,11]]},"abstract":"\n Introduction<\/jats:title>\n Peroral endoscopic myotomy (POEM) is a novel endoscopic procedure used to treat achalasia and other spastic esophageal disorders that is an alternative to Heller myotomy. We seek to define the learning curve of POEM for a foregut surgeon with no formal endoscopic or POEM training by analyzing different intraoperative factors in a single series.<\/jats:p>\n <\/jats:sec>\n \n Methods and Procedures<\/jats:title>\n The first 38 consecutive patients undergoing POEM by a single foregut surgeon were included in this retrospective study. Inverse curve regression models were used to analyze total operative time (TOT) and total operative time per centimeter of myotomy (TOT-CM), in addition to other intraoperative variables. Clinical outcomes were reported as pre- and post-operative Eckardt Scores.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n All patients had type II achalasia with no post-operative complications observed. Eckardt scores improved postoperatively (median (range): 1 (0-4)) compared with the preoperative scores (10 (8-12)) (P < .001). The total operative time (median 76\u00a0minutes, range 51-129) decreased significantly over the course of the series (R\n 2<\/jats:sup>\n = .38, P < .001), with a learning plateau at 70\u00a0minutes and a learning rate of 12 cases. Total operative time per centimeter of myotomy (median 7.08\u00a0min\/cm, range 4.25 to 15.38) decreased over time (R\n 2<\/jats:sup>\n = .45, P < .001), with a learning plateau at 7\u00a0minutes\/cm and a learning rate of 12 cases.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The number of cases for a foregut surgeon to become proficient in a POEM procedure was found to be 12-14 cases. The learning curve for a POEM in a formally trained foregut surgeon may be comparable to an endoscopically trained interventionist.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00031348221109457","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T22:44:01Z","timestamp":1655419441000},"page":"4305-4309","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Peroral Endoscopic Myotomy; Novice Surgeon Learning Curve"],"prefix":"10.1177","volume":"89","author":[{"given":"Gregory H.","family":"Bach","sequence":"first","affiliation":[{"name":"Department of General Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winston","family":"Crowell","sequence":"additional","affiliation":[{"name":"Undergraduate Medical Education, Morsani College of Medical Education, University of South Florida, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Griffith","sequence":"additional","affiliation":[{"name":"Undergraduate Medical Education, Morsani College of Medical Education, University of South Florida, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Rachman","sequence":"additional","affiliation":[{"name":"Department is Undergraduate Medical Education, University of South Florida Morsani College of Medicine, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9230-341X","authenticated-orcid":false,"given":"Alec","family":"Bigness","sequence":"additional","affiliation":[{"name":"Department is Undergraduate Medical Education, University of South Florida Morsani College of Medicine, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department is Undergraduate Medical Education, University of South Florida Morsani College of Medicine, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Sujka","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Mhaskar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"DuCoin","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"bibr1-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1391668"},{"key":"bibr2-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002311"},{"key":"bibr3-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1244080"},{"key":"bibr4-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.10.002"},{"key":"bibr5-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-104113"},{"key":"bibr6-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2012.12.006"},{"key":"bibr7-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-013-2332-0"},{"key":"bibr8-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5151-z"},{"key":"bibr9-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/389596"},{"key":"bibr10-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1191\/1740774504cn042oa"},{"key":"bibr11-00031348221109457","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12197"}],"container-title":["The 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