Jan 3, 2023

MILESTONE MOMENT: SHEIKH SHAKHBOUT MEDICAL CITY CONDUCTS ABU DHABI’S FIRST Z-POEM PROCEDURE

MILESTONE MOMENT: SHEIKH SHAKHBOUT MEDICAL CITY CONDUCTS ABU DHABI’S FIRST Z-POEM PROCEDURE
Swallowing disorders have a significant impact on both the quality of life and nutrition of patients. Minimally invasive endoscopic procedures, such as Z-POEM, result in quicker recovery

Sheikh Shakhbout Medical City (SSMC), one of the UAE’s largest hospitals for serious and complex care and a joint-venture partnership between Abu Dhabi Health Services Company (SEHA) and Mayo Clinic, successfully conducted Abu Dhabi’s first Zenker’s peroral endoscopic myotomy (Z-POEM) procedure on a female patient. Z-POEM is a non-invasive procedure to treat Zenker’s Diverticulum (ZD), a rare condition affecting less than 0.01% of people. It is a pouch that can form at the back of the throat. If left untreated, food and saliva can become trapped in it over time, making it increasingly difficult to swallow and nourish.

A patient who was recently treated in one of the first cases in the region had trouble swallowing for over ten years. She had difficulty enjoying a meal, would often cough and choke, had difficulty breathing, and food would get stuck in the esophagus and then go into her windpipe. Over time, she started avoiding solid foods that caused her discomfort and moved to a liquid diet. SSMC recommended the minimally invasive option to her as ZD was significantly interfering with her quality of life and nutrition and causing discomforts.

Dr. Michael Wallace, chair, Division of Gastroenterology and Hepatology, SSMC, said: “For rare and complex conditions like ZD, patients usually have to be treated at a referral center that has the expertise and skills to treat them, like SSMC or Mayo Clinic.”

“Swallowing disorders significantly impact both the quality of life and nutrition. SSMC now offers Z-POEM to our patients as a minimally invasive alternative to the traditional surgical approach. Keyhole endoscopic procedures, such as Z-POEM, result in quicker recovery. It can be performed as an outpatient procedure or with patients spending a night for observation, as was the case with this particular patient.”

Since the patient had been suffering from the condition for so many years, it took three to four weeks for her esophagus to revert to a relatively normal state where she could swallow regular foods, meat, bread, vegetables, and fruits as opposed to just liquids.

Dr. Alain Sabri, chair, Division of Otolaryngology-Head and Neck Surgery (ENT), said: “We are thrilled to be able to offer our patients these minimally invasive, cutting-edge procedures through multidisciplinary teamwork with good outcomes, short hospitalizations, high patient satisfaction, and excellent functional results.”

The patient, Awatif Bashir, said: “The disease interfered with my daily life. I could not sleep properly due to excessive phlegm in my throat and coughing. Every time I ate, I felt like choking and could not breathe. I started avoiding fiber meals because of that. It was too embarrassing to eat outside with friends and relatives because of the swallowing difficulty. Today, I can eat a normal meal with my loved ones, and I am leading a healthy, normal life indulging in foods I have avoided for a long time. I am grateful to the team at SSMC for bringing this joy and quality back to my life and for their continuous support throughout my treatment at the hospital.”

Led by Dr. Wallace and Dr. Sabri, a dedicated team of gastroenterologists, otolaryngology-head and neck surgery (ENT) consultants, nurses, anesthesiologists, radiologists, nutrition experts, internists, and speech and language/swallowing therapists were involved in ensuring the procedure was carried out successfully. Dr. Wallace added, “Good follow-up and treatment will ensure that the symptoms won’t return.”

Dr. Matthew Gettman, chief medical officer at SSMC, highlighted: “Zenker’s diverticulum is a good example of a rare condition for which we’ve developed expertise. At SSMC, we are dedicated to bringing life-changing advancements, research, and discoveries, actively applying novelty to the care delivered to our patients one at a time, and elevating the standard of care through breakthrough innovation.

“We identify capacity gaps and needs in the health care services in the emirate and invest in the right infrastructure and resources to address those needs. Our goal is to support bringing trust to health care delivery in Abu Dhabi and keep residents and citizens from traveling abroad for treatment.”