About Third Space Endoscopy

Third Space Endoscopy refers to advanced endoscopic techniques that utilize the submucosal space—the area between the mucosal and muscular layers of the digestive tract—to perform complex therapeutic procedures. This innovative approach includes Endoscopic Submucosal Dissection (ESD) and Per-Oral Endoscopic Myotomy (POEM), which represent significant advancements in minimally invasive gastrointestinal interventions. ESD enables en bloc removal of early-stage cancers and precancerous lesions throughout the digestive tract, providing intact specimens for comprehensive pathological assessment. POEM treats achalasia and related esophageal motility disorders by precisely targeting the muscular layer of the esophagus. Our clinic offers these cutting-edge procedures performed by specialists with extensive training in advanced endoscopic techniques, providing alternatives to traditional surgery with reduced recovery time and fewer complications.

Why It Happens

Third Space Endoscopy procedures are performed to address specific digestive tract conditions that previously required more invasive surgical intervention. ESD is indicated for removing early-stage gastrointestinal cancers, large precancerous polyps, and other lesions that require precise, complete removal with intact margins for accurate staging and diagnosis. This technique is particularly valuable for lesions that would be difficult to remove completely with standard endoscopic methods. POEM is primarily used to treat achalasia—a condition where the lower esophageal sphincter fails to relax properly—causing difficulty swallowing, regurgitation, and chest pain. By accessing the muscular layer through the submucosal space, POEM allows for precise myotomy (muscle cutting) to relieve obstruction at the gastroesophageal junction. These advanced procedures offer significant advantages including organ preservation, reduced recovery time, and minimal scarring compared to conventional surgical approaches.

How We Help

We provide specialized Third Space Endoscopy services with a focus on technical excellence and patient-centered care. Our expert gastroenterologists have undergone extensive training in these advanced techniques and utilize state-of-the-art equipment specifically designed for ESD and POEM procedures. For ESD, we offer comprehensive evaluation, precise lesion removal, and detailed pathological assessment to guide further treatment decisions. Our POEM service includes thorough diagnostic workup using high-resolution manometry, customized procedural planning, and dedicated follow-up care to optimize outcomes for patients with achalasia and related disorders. We emphasize multidisciplinary collaboration with oncologists, surgeons, and pathologists to ensure integrated care for complex cases. Our team provides detailed pre-procedure counseling, appropriate sedation or anesthesia during the procedure, and comprehensive post-procedure care including specific dietary guidelines and medication management. We monitor long-term outcomes and maintain ongoing communication with referring physicians to ensure continuity of care.