Creation of a submucosal tunnel / Submucosal Tunneling

Submucosal Tunneling is an advanced endoscopic technique in which a controlled passage (tunnel) is created in the submucosal layer of the esophagus, between the mucosa and the muscle layer. This approach enables access to the muscle layer to perform a precise myotomy, without injuring the mucosa or making external incisions or opening the chest cavity.

The technique is performed under full direct visualization, with precise control of the direction, depth, and length of the tunnel, and allows:

• Safe and targeted access to the esophageal muscles and the lower esophageal sphincter
• Reduced risk of injury to adjacent tissues
• Preservation of the integrity of the esophageal wall
• Faster recovery compared to open or laparoscopic surgeries

Submucosal Tunneling forms the foundation for the Third Space Endoscopy technique and requires advanced endoscopic skill, significant experience, and in-depth knowledge of the anatomy of the esophageal wall.