Third space endoscopy has evolved significantly over the last decade. It refers to the endoscopic procedures performed in the space between muscularis mucosae and muscularis propria of the gastrointestinal tract. Presently it has a wide range of potential applications ranging from motility disorders treatment, submucosal tumours resection and diverticular management. The main technique while performing the third space endoscopic procedure is creating a submucosal tunnel, performing the desired procedure and closing the mucosal defects. Per oral endoscopic myotomy is the most commonly performed third space endoscopy procedure. It has now become the procedure of choice for type 3 Achalasia Cardia and has shown comparable efficacy to laparoscopic Heller’s myotomy. This review comprehensively covers the various aspect of the third space endoscopy procedures including their indication, contraindications, and methods with their outcomes.
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