The west's biggest hospital is the first in the country to introduce incision-less, minimally invasive surgery to help correct blockages of the oesophagus.
The procedure is being carried out at University Hospital Galway by Mr Paul Carroll, a consultant oesophagogastric and general surgeon who specialises in minimally invasive and endoscopic surgery for oesophago-gastric cancer and benign disease.
This new surgery helps correct achalasia, a rare condition which causes a blockage in the muscles of the lower oesophagus. This results in dysphagia or difficulty swallowing, even liquids, in pronounced cases.
Traditionally, the treatment of achalasia involved procedures to repeatedly open the oesophagus or, alternatively, required laparoscopic (keyhole or minimally invasive ) surgery. The traditional method divided the muscles of the lower oesophagus through several small incisions in the abdomen.
However, UHG surgeons have now undertaken an incisionless procedure using Peroral Endoscopic Myotomy (POEM ). It uses an endoscope, a narrow flexible tube with a camera, to breach the lining of the oesophagus. The endoscope is inserted through the mouth and can be positioned into the space between the oesophageal lining and the muscles, allowing it to divide these muscles internally. The breach is then closed with special clips.
One of the significant benefits of this procedure is that it can treat a subtype of achalasia with chest pain. This requires a longer division of the muscles along the length of the oesophagus, which is traditionally challenging to treat with standard surgery. POEM can also be used as a rescue or second line intervention where other treatments have failed. Patients are discharged the following morning without pain and with their symptoms resolved.
The introduction of this procedure has added to the expanding minimally invasive upper gastrointestinal (GI ) programme in Galway and in the Saolta University Health Care Group, which runs the public hospitals in the west and north-west. UHG is also one of only two centres in Ireland which provides endoscopic surgical interventions for early oesophageal and gastric cancers.
Mr Paul Carroll, the Galway based consultant oesophagogastric and general surgeon, who is undertaking the incisionless surgery for blockages of the oesophagus, thanked his team for makign this procedure available to Irish patients.
"I am personally delighted that I have been able to introduce this procedure into Ireland for treatment of this disease process. It would not have been possible without the support and training I received whilst on fellowship in the University of Toronto and finally without the unwavering support of the late Marie Farragher, clinical nurse manager in theatre and her team of nurses for pushing boundaries with me."
Chris Kane, the general manager of Galway University Hospitals [UHG and Merlin Park University Hospital] also praised the innovation adding: "These innovations focus on and enhance the patient experience. They improve care and treatment options for all our communities and we are delighted to add this innovative surgery at GUH."
