1. How Many Peroral Endoscopic Myotomy Procedures Are Necessary for Proficiency? 
Rani Modayil, MD 
Clinical Gastroenterology and Hepatology 
Volume 16, Issue 9, Pages (September 2018)
DOI: /j.cgh
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2. Figure 1
Typical CUSUM analysis of the POEM learning curve based on the first 93 consecutive cases of this author.
Clinical Gastroenterology and Hepatology  , DOI: ( /j.cgh )
Copyright © 2018 AGA Institute Terms and Conditions

3. Figure 2
Procedure times for the first 318 POEMs of this author and mean procedure times for consecutive 80-procedure blocks. The figure illustrates that an “inverse curve fit” analysis on the first 60 cases would grossly overestimate the learning plateau at ∼90 minutes. With the hindsight of the subsequent 258 cases we can see that the mean procedure time continues to improve well beyond 240 procedures with the learning plateau at well below the 59 minute mean procedure time for the last block of procedures ( ). PT, procedure time.
Clinical Gastroenterology and Hepatology  , DOI: ( /j.cgh )
Copyright © 2018 AGA Institute Terms and Conditions