Rela Hospital Performs Tamil Nadu’s First Paediatric POEM Procedure on Eight-Year-Old
Chennai: Rela Hospital has performed Tamil Nadu’s first reported paediatric Peroral Endoscopic Myotomy (POEM) procedure on an eight-year-old boy diagnosed with Type II achalasia cardia, a rare disorder that affects the nerves controlling the food pipe (oesophagus) and causes difficulty in swallowing.
The child had experienced progressively worsening difficulty swallowing both solid food and liquids. Following the procedure, he recovered satisfactorily and was able to resume clear liquids and subsequently a soft diet within 24 hours.
Achalasia cardia occurs when the lower oesophageal sphincter, the muscular valve connecting the food pipe to the stomach, fails to relax properly, preventing food and liquids from passing normally. The condition is extremely rare among children, affecting an estimated 0.1–0.18 per 100,000 children annually. If untreated, it can affect nutrition, growth and overall health.
Unlike conventional laparoscopic surgery, which involves abdominal incisions and typically requires three to four days of post-operative care, POEM is performed entirely through the mouth. An endoscope is used to create a small tunnel within the oesophageal wall, allowing surgeons to divide the tight muscle fibres without external incisions or visible scars.
The procedure was performed by Dr. SNK Chenduran, Senior Consultant and Endoscopic Surgeon, Department of Medical Gastroenterology, with support from the anaesthesia, paediatric and nursing teams. The procedure took approximately 50 minutes.
Dr. Chenduran said performing POEM in children requires considerable technical precision because their oesophagus is smaller and narrower than that of adults, leaving limited working space. He added that careful dissection is essential to avoid damaging delicate tissues.
Dr. Dinesh Jothimani, Director of Hepatology and Medical Gastroenterology at Rela Hospital, highlighted the importance of early diagnosis. He urged parents to watch for symptoms such as difficulty swallowing food or water, regurgitation of undigested food, repeated vomiting, unexplained weight loss and coughing while eating.
He cautioned that persistent swallowing difficulties should not be dismissed as ordinary eating problems, as delayed treatment could lead to malnutrition, poor weight gain and food entering the lungs.
Prof. Mohamed Rela, Chairman and Managing Director of Rela Hospital, said that although POEM is an established treatment for adults with achalasia, performing it in children requires specialised expertise and a higher degree of technical precision. He described the procedure as a milestone for advanced therapeutic endoscopy in Tamil Nadu.
