A WHITBY man was given a new lease of life when The James Cook University Hospital in Middlesbrough became the first in northern England to undertake a per-oral endoscopic myotomy procedure – or POEM for short.
POEM is a minimally invasive surgical procedure for the treatment of achalasia, a disorder of the oesophagus (gullet) that makes it hard for foods and liquids to pass into the stomach.
Ten years ago, Whitby taxi driver Brian Murfield started to regularly have indigestion and occasional problems with swallowing, often regurgitating his food.
Brian, 59 was diagnosed with achalasia and as the years went by his condition got worse until he collapsed at a football match and ended up at James Cook.
Brian had collapsed because he had become badly dehydrated, the result of his achalasia getting worse. It was decided that Brian needed a myotomy sooner rather than later. He was given the option of having a POEM procedure.
Brian said the procedure had changed his life. He said “I don’t regurgitate any more, I don’t get reflux. I’ve lost weight and I haven’t felt this well in ten years or more. I feel great.”
The procedure was undertaken by Professor Viswanath YKS, consultant surgeon at South Tees Hospitals NHS Foundation Trust, and his team, supported by Dr Anjan Dhar, consultant gastroenterologist at County Durham and Darlington NHS Foundation Trust and Dr Matt Banks, consultant gastroenterologist at University College London Hospitals.
Brian said: “I was given the option to which hospital to be sent to and I picked James Cook, because as a taxi driver I’ve taken a few people up there and they always talk about how good their treatment has been.”
Professor Viswanath YKS, who led on the procedure for the Trust, said: “A myotomy is performed to alleviate symptoms of dysphagia due to achalasia. This is a surgical procedure in which the muscles in the area of the stomach that directly receives contents from the oesophagus are cut, allowing food and liquids to pass to the stomach. This usually requires external incisions or cuts but the POEM procedure means this can be avoided, making it less invasive. We cut the muscle from inside, via the lining of the gullet using an endoscope.”
Brian decided to go ahead with the procedure. He said: “The procedure is usually done under general anaesthetic and I would only have to stay in hospital for one to two days. I agreed at which point Dr Dhar told me that they were off to London to learn how to do it! I’ll admit, that threw me a bit but it was a no brainer – I had confidence in them.”
Professor Viswanath YKS said: “As POEM is a less invasive procedure, the patient’s recovery period is quicker. It can change a person’s life from the point of being able to swallow and eat, which obviously benefits their social life too. It has proven to be a successful procedure in selected patients, but it’s not for everybody.
“James Cook is the first hospital to undertake this procedure across the whole of northern England and Scotland. There are only another few hospitals that do POEM procedures and they are in London, Nottingham and Portsmouth. We started this in collaboration with other specialist endoscopy colleagues across the north east. It was a real team effort.”
Brian was discharged two days after the operation and is already showing excellent recovery.
He said: “I was put on a liquid diet for the next five weeks which I know sounds horrible but it was fine. In fact I discovered smoothies and now I love them. And I got used to blending some of the foods I love – like cottage pie. It looked awful, but when you closed your eyes it tasted great. And after that I started eating solid food again.
“In many ways the work of Dr Viswanath and Dr Dhar changed my life.”