Evidence map›Paper›PMID 42403146›Full record

ReviewThe Journal of international medical research2026

Third-space endoscopy: Current techniques, clinical applications, and future directions.

Zaheer Nabi, Azimuddin Haza, Duvvur Nageshwar Reddy

Abstract readReview
In one paragraph

Review in The Journal of international medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Zaheer NabiDepartment of Gastroenterology, Asian Institute of Gastroenterology, India.ORCID 0000-0003-2713-4781
Azimuddin HazaDepartment of Gastroenterology, Asian Institute of Gastroenterology, India.
Duvvur Nageshwar ReddyDepartment of Gastroenterology, Asian Institute of Gastroenterology, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Third-space endoscopy refers to a set of endoscopic techniques that allow access to the submucosal space or "third space" between the mucosa and muscularis propria, enabling therapeutic intervention while preserving mucosal integrity. The unifying concept across all third-space endoscopy procedures is the creation of a submucosal tunnel with a mucosal flap acting as a safety valve, allowing separation of access from therapy. This principle is the key factor underlying its rapid adoption across diverse indications. The evolution of third-space endoscopy began with the submucosal endoscopy with mucosal flap technique, followed by the first porcine per-oral endoscopic myotomy and its clinical application in humans nearly two decades ago. Per-oral endoscopic myotomy has not only transformed the management of achalasia but also established a platform that has since been extended to multiple gastrointestinal disorders, including per-oral endoscopic myotomy for refractory gastroparesis, submucosal tunneling endoscopic resection for sub-epithelial tumors, Zenker's per-oral endoscopic myotomy, and per-oral endoscopic myotomy for epiphrenic diverticula. Although some procedures, such as per-oral endoscopic myotomy and tunneling resection for subepithelial tumors, have matured with well-defined roles in clinical algorithms, others, including per-oral endoscopic myotomy in refractory gastroparesis and Zenker's per-oral endoscopic myotomy, demonstrate promising safety and efficacy but continue to face unresolved questions regarding patient selection, durability, and comparative effectiveness. Despite these limitations, third-space endoscopy has emerged as a minimally invasive alternative for several conditions traditionally managed surgically. Its standardized core principles allow broad adaptability across disease phenotypes. This narrative review discusses the evolution, technical framework, clinical outcomes, and current limitations of key third-space endoscopy procedures.

Indexed as

EndoscopyAnimalsEsophageal AchalasiaHumansMyotomyZenker Diverticulumachalasiagastroparesisper-oral endoscopic myotomysubmucosal tunnelingThird-space endoscopy

Identifiers

PMID42403146
PMCPMC13338515

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.