Submucosal endoscopy, also known as third space endoscopy, is based on the idea that it is possible to tunnel in the submucosal space and access the deeper layers of the GI tract without affecting the integrity of the mucosa above. The first and second spaces are typically the lumen and extra-intestinal, respectively, of the intestine. Therefore, the third space is the area inside the gut wall that is in between the first two spaces. Per Oral Endoscopic Myotomy (POEM) and Endoscopic Submucosal Dissection are the two most frequent procedures carried out in the third space (ESD). Achalasia, diffuse esophageal spasm, jackhammer esophagus, and obstruction of the esophagogastric junction outlet are just a few examples of the motility problems of the esophagus that can be treated with the minimally invasive endoscopic surgery known as POEM (EGJOO). Similar to a regular upper endoscopy, POEM is conducted, but it calls for specialized equipment and expertise. A minimally invasive endoscopic surgery called ESD is used to remove lesions from the GI system, including early malignancies and advanced polyps from the esophagus, stomach, colon, and rectum. Thus, the primary objective of ESD is to spare patients who have lesions that can be removed endoscopically from needless surgery. Third Space Endoscopy requires extremely specialized techniques that have largely replaced many common surgical procedures. While maintaining the same standards as other surgical treatments, the technique ought to speed up recovery periods.
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