The foundation of third space endoscopy, also known as submucosal endoscopy. The term "third space endoscopy" refers to a variety of endoscopic treatments that are carried out in the GI tract's potential third space. It is based on the idea that the deeper layers of the GI tract can be reached by tunneling in the submucosal space without endangering the integrity of the mucosa above. Typically, the first and second spaces are the regions inside the lumen of the gut and the exterior of the intestine i.e. space used in laparoscopic surgeries. Therefore, the third space is the area inside the gut wall that is in between the first two spaces. The two most frequent operations carried out in the third area are endoscopic submucosal dissection (ESD) and per oral endoscopic myotomy (POEM). As a minimally invasive endoscopic operation, POEM is used to treat esophageal motility abnormalities like achalasia, diffuse esophageal spasm, jackhammer esophagus, and obstruction of the esophagogastric junction outlet (EGJOO). Similar to a regular upper endoscopy, POEM is conducted, but it calls for specialized equipment and expertise. To remove lesions from the GI tract, such as advanced polyps and early malignancies from the esophagus, stomach, colon, and rectum, doctors use the minimally invasive endoscopic treatment known as ESD. Third Space Endoscopy entails extremely sophisticated techniques that have replaced several traditional surgical operations.
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