Per-Oral Endoscopic Myotomy (P.O.E.M.) for Treatment of Esophageal Motility Disorders

Inclusion Criteria: * All patients with age ranged 18 to 80 who had primary esophageal motility disorders will be recruited. The primary motility disorders included: Achalasia, hypertensive LES, Nutcracker esophagus and Diffuse esophageal spasm. Exclusion Criteria: * Patients will be excluded from this study with the followings - 1. Pregnancy 2. Informed consent not available 3. Previous history of esophagectomy or mediastinal surgery 4. Previous history of endoscopic resection for early esophageal cancers, including endoscopic mucosal resection and endoscopic submucosal dissection 5. End-stage Achalasia with dilated esophagus more than 6cm on Barium swallow