Peroral Endoscopic Myotomy (POEM) Cost in India

 What is POEM (Peroral Endoscopic Myotomy) Surgery?

POEM (Peroral Endoscopic Myotomy) is an advanced endoscopic procedure used to treat achalasia cardia—a rare disorder that affects the esophagus, making it difficult to swallow. In this procedure, a flexible endoscope is inserted through the mouth to access the esophageal muscles. The inner circular muscle layer is then cut to allow smoother passage of food into the stomach.

Unlike traditional surgical methods like laparoscopic Heller myotomy, POEM is done without any external cuts, making it a scarless and faster recovery option. It is considered one of the most effective and safest options for long-term symptom relief in achalasia patients.

Who Needs POEM Surgery?

POEM surgery is recommended for:

· Patients diagnosed with achalasia or similar esophageal motility disorders

· Individuals who have failed previous treatments, such as balloon dilation or Heller myotomy

· Patients with spastic esophageal disorders (e.g., jackhammer esophagus)

· Adults and adolescents with progressive difficulty in swallowing, regurgitation, or chest pain

· Patients looking for a minimally invasive treatment with quicker recovery and fewer complications

If you're an international patient experiencing these symptoms, POEM surgery in India could be the ideal solution due to the cost advantage and high-quality care.

What Are the Types of POEM Procedures?

POEM surgery can be categorized into:

1. Standard POEM

o Ideal for most achalasia patients

o Involves cutting only the inner circular muscle layer of the esophagus

o Typical length of myotomy: 6–10 cm

2. Extended POEM

o Used for complex or long-standing achalasia cases

o Myotomy can extend into the stomach for better outcomes

3. Posterior POEM vs Anterior POEM

o Refers to the approach of entry (back or front side of the esophagus)

o Selection depends on the surgeon’s expertise and anatomy

4. G-POEM (Gastric POEM)

o Used for treating gastroparesis, a different motility disorder of the stomach

o Similar technique but targeted at the pyloric sphincter

India’s leading gastroenterology hospitals offer all these POEM variants with expert customization based on patient conditions.

What Is the Detailed Treatment Protocol for POEM Surgery in India?

The typical treatment process for POEM surgery in India for international patients includes the following steps:

1. Pre-Arrival Coordination

· Healzone arranges online consultation with the surgeon

· Medical history and reports are reviewed

· Treatment plan, visa assistance, and travel support are provided

2. Pre-Surgical Workup

· On arrival, the patient undergoes:

o High-resolution esophageal manometry

o Barium swallow test

o Upper GI endoscopy

o Routine blood tests and ECG

3. Surgery Day

· The procedure is done under general anesthesia

· A flexible endoscope is passed into the esophagus via the mouth

· A tunnel is created in the inner lining of the esophagus

· The circular muscle is cut to relieve the obstruction

· No external incisions are made

· Duration: 45 to 90 minutes

4. Post-Operative Care

· Patient remains under observation for 24–48 hours

· Gradual shift from liquid to soft diet

· Monitoring for symptoms like gas bloating, chest discomfort

· Discharge typically within 2–3 days

5. Follow-Up

· Regular virtual follow-ups can be scheduled

· Complete dietary guidelines and medication support

· Healzone provides ongoing patient support after return to home country

What Devices and Technologies Are Used in POEM Surgery?

POEM surgery is a highly specialized procedure that uses advanced endoscopic tools and state-of-the-art technologies, such as:

· High-definition therapeutic endoscope – Allows clear internal visualization.

· Electrosurgical knife (e.g., triangle tip knife, hybrid knife) – Used for precise muscle cutting.

· CO2 insufflation system – Prevents complications like gas embolism.

· Endoclips or sutures – To close the entry tunnel after myotomy.

· Manometry system – For diagnosis and post-operative pressure studies.

India’s top gastroenterology centers are equipped with these technologies to ensure the highest safety and precision.

What Are the Advantages of POEM Surgery Over Traditional Methods?

POEM surgery offers multiple advantages over open or laparoscopic surgery:

This makes POEM the preferred option, especially for international patients seeking faster healing and minimal discomfort.

Why Choose India for POEM Surgery?

India has emerged as a global hub for POEM surgery due to several reasons:

· Highly experienced gastroenterologists and surgeons trained in Japan, USA, and Europe

· Use of international-standard medical equipment and JCI/NABH-accredited hospitals

· Shorter waiting times compared to Western countries

· Seamless medical visa process and affordability

· Personalized medical tourism services for international patients

Moreover, India offers cost savings up to 70% compared to the USA or UK without compromising on quality.

Why Choose Healzone for POEM Surgery in India?

Healzone is a trusted medical tourism platform that ensures: 

 1. Hospital Type and Location

• Tier-1 metro cities like Delhi, Mumbai, and Bangalore often have higher hospital charges than smaller cities.
   
• JCI or NABH-accredited hospitals may cost more due to international standards and advanced infrastructure.

2. Surgeon’s Expertise and Reputation

• Experienced gastroenterologists trained in Japan/USA or POEM pioneers charge higher fees.
   
• Surgeons at premium hospitals or those with a high success rate may influence the cost.
   

3. Diagnostic and Preoperative Tests

• Required tests such as esophageal manometry, barium swallow, and endoscopy add to the total cost.
   
• Comprehensive pre-surgical evaluation can increase expenses by $300–$600.

4. Hospital Stay Duration

• Standard stay is 2–3 days, but extended observation or ICU stay for complex cases raises the cost.
   
• Room category (general, semi-private, private) also affects pricing.

5. Type of POEM Procedure

• Standard POEM is less expensive.
   
• Extended POEM or G-POEM (used for gastroparesis) involve longer procedure times and more resources, thus increasing the cost

6. Anesthesia and Operation Theatre Charges

• General anesthesia, anesthesiologist’s fee, and operation theatre time significantly impact total expenses.
   
• High-end technology like CO2 insufflation systems also adds to the cost.

 7. Medical Technology and Equipment Used

• Usage of advanced tools like HD endoscopes, hybrid knives, and manometry systems can raise the cost.
   
• Hospitals with cutting-edge gastroenterology suites may charge more.

 8. Post-Operative Care and Medication

• Includes hospital stay, dietary support, and medications for recovery.
   
• Some packages may include follow-up consultations and post-discharge care, affecting the final cost.

 9. International Patient Services

• Services like visa invitation letters, airport pickup, translator assistance, and accommodation provided by medical tourism facilitators like Healzone can add to the service fee but offer convenience and value

10. Insurance and Payment Options

• Some Indian hospitals accept international health insurance which can reduce out-of-pocket costs.

Cash vs insured billing can result in different pricing structures.

 What Are the Advantages of POEM Surgery Over Traditional Methods?

POEM surgery offers multiple advantages over open or laparoscopic surgery:

This makes POEM the preferred option, especially for international patients seeking faster healing and minimal discomfort.

Risk factors and potential complications:

1. Gastroesophageal Reflux Disease (GERD)

• POEM disrupts the lower esophageal sphincter, increasing the risk of acid reflux.
   
• Around 20–40% of patients may experience post-operative GERD symptoms.
   
• Long-term proton pump inhibitor (PPI) therapy may be required.

 2. Mucosal Injury or Perforation

• Rare but serious complication during the creation of the submucosal tunnel.
   
• Requires immediate intervention and endoscopic repair or rarely, surgical correction.
   
• Risk is less than 2% in experienced hands.

3. Pneumoperitoneum or Pneumomediastinum

• Due to insufflation of CO? during the procedure, air may escape into the abdominal or chest cavity.
   
• Usually self-limiting but may require observation or needle decompression.

4. Postoperative Bleeding

• Minor bleeding from the submucosal tunnel or myotomy site.
   
• Typically managed endoscopically with endoclips or cauterization.
   
• Severe bleeding is rare.

5. Infection or Abscess

• Infection of the tunnel or mediastinum can occur, especially if mucosal integrity is compromised.
   
• Prevented with prophylactic antibiotics and sterile technique.
   
• Can require IV antibiotics or drainage.

6. Gas Bloating and Chest Discomfort

• Common temporary side effects due to CO? insufflation or altered esophageal pressure.
   
• Usually resolves within a few days with diet and medication.

7. Sore Throat or Hoarseness

• From endoscope insertion; usually mild and temporary.
   
• Disappears within 24–48 hours post-procedure.