This interview originally aired on 10/07/2026 on South Texas Midday.
ROB BOSCAMP: Joining me is Dr. Juliana Yang, a gastroenterologist at UT Health RGV, and professor of medicine at the University of Texas Rio Grande Valley School of Medicine. Back in August, UT Health RGV performed its first peroral endoscopic myotomy, or POEM, procedure in partnership with Rio Grande Regional Hospital. They are the first providers in the region to offer the treatment. In the past, people living with conditions that make swallowing difficult or prevent food from moving properly through the digestive system have had to travel far to seek specialized treatment. Dr. Yang, thank you for joining me today. Start by telling me about the need that South Texas residents have for this type of procedure.
DR. JULIANA YANG: When I first came to the Rio Grande Valley, I noticed very early on, that patients with GI dysmotility issues such as achalasia and gastroparesis are being sent out hundreds of miles away to like San Antonio, Dallas, Houston, Austin for this specialized procedure. So at that time, you know, I think it would be a great addition to the care here for the people here in Rio Grande Valley. Because those trips are very long. And second of all is that this patient needs repeated follow-ups and overnight stays, which makes the care very expensive for the families and for the patient. So that's when I thought it would be really nice to bring that kind of teacher here to the people in the Rio Grande Valley.
ROB BOSCAMP: What was the inspiration to pursuing making this procedure available in South Texas?
DR. JULIANA YANG: When I was training at Hopkins, my mentor actually developed one of these kind of procedures, so I trained with him. And then when I was at Vanderbilt, we launched this procedure for the tri-state area. We had a very large number, partly because of the incidence of diabetes— in those tri-state areas in the southern states — so, we did probably close to probably more than 200 cases or so during the year-and-a-half we did this procedure over there. And it was interesting because one of the patients had a really good outcome. This patient was actually a friend to another patient who flew all the way from Nashville to find me here in the Greater Rio Grande Valley; and they came to see me in clinic all the way from Nashville, and with the symptoms because they went to the same church. So, this patient and my other patient apparently went to the same church, and they talked about it. So he flew all the way here to see me. And you know, at the time, he was a really good candidate. I really felt like he would be a perfect candidate for this kind of procedure. So, I worked closely with the Rio Grande PACS nurses and their endoscopy department, and with the insurance here at UTRGV, and we were able to successfully complete this procedure. And now, we have several more procedures lined up for the patients here in the valley now. So I think it's going along quite nicely.
ROB BOSCAMP: What does the future hold for having the POEM procedure available in the region?
DR. JULIANA YANG: I expect the volume to increase because here in the valley, diabetes is prevalent. It's very common, and with diabetes, if not well controlled, people develop gastroparesis, and you know treatment for
gastroparesis, one, it's very limited; two, the medication and stuff don't really work well, especially for long term. So this procedure will add a lot of value to patients suffering from those symptoms like the gastroparesis. Furthermore, you know there are achalasia patients here too, so although achalasia is considered more like not as common as hypertension and you know hyperlipidemia, things like that, but people who have it suffers a great deal. So even if we can make a difference to one patient, I think it's invaluable to that patient.
ROB BOSCAMP: Is the procedure out of the ordinary when compared to other surgery options?
DR. JULIANA YANG: Yes. So this is a off-branch from what we considered typical lumen endoscopy. So what I mean by that this is actually categorized under the category of what we call the third lumen endoscopy. So POEM creates an artificial tunnel between the layers of the linings of our intestines. It's a completely man-made area. That's why we call it the third movement. So from that, you know, it's kind of like peeling off the wallpaper from the wall. If you imagine it, and then break down the muscle, which is like the bricks behind the wallpaper. Then we "tape" the wallpaper back on. The analogy is kind of like that, if you think about it that way. So basically, there's nothing on the outside. So patient recovery is essentially extremely minimal. They just stay overnight, really. And there's no incision on the outside at all. So everything's done inside. So this minimizes the pain patient experiences, the duration of the hospitalizations and infections and those things that are commonly associated with external incisions.
ROB BOSCAMP: You mentioned earlier how far people travel for the surgery, and you've seen that firsthand. Is a "Tennessee to Texas" trip the furthest you've heard of someone traveling?
DR. JULIANA YANG: Actually, people — because it's still a very specialized procedure and very few people are actually trained in it. Normally when we do it, we go through med school residency, GI fellowship. Usually, the advanced fellowship is only one year, but I did two years at Hopkins. So, with the person who developed this procedure, I was able to really learn it firsthand. During my career, patients actually have followed me all all across the place that I've worked. So every place I worked, I think patients from Nashville, or the other areas, has found me and came to have this procedure done.
ROB BOSCAMP: Besides the conditions we've mentioned, is the POEM procedure able to treat other conditions?
DR. JULIANA YANG: POEM is actually kind of like a general term. So POEM is actually made of a family of procedures. So the most common ones are for the gastroparesis, which is called the G-POEM, and for achalasia treatment, which is dysmotility of the esophagus. So, that's called the E-POEM. There are other families of POEM as well. And then there are like offshoots and variations of POEM. So there are different diseases that we can treat minimal invasively nowadays with the technique.
ROB BOSCAMP: With the first procedure being a success, what can South Texas residents look forward to in the future?
DR. JULIANA YANG: With this kind of procedure closer to home, I think it really will take off a lot of the stress and the logistics and resources the patient need to allocate. We travel hundreds of miles away to, you know, next big activity for this kind of procedures. So with this being available, I feel like this will be a very unique, and also a very useful procedure, to add to the bucket list of the cares that the people here in the Rio Grande Valley can receive instead of spending so much time and energy and money to travel elsewhere, hundreds of miles away for repeated appointments, overnight stays, etc.
ROB BOSCAMP: That is Dr. Juliana Yang, a gastroenterologist at UT Health RGV, and professor of medicine at the University of Texas Rio Grande Valley School of Medicine. She was speaking about the paroral endoscopic myotomy or POEM procedure now available in the South Texas region. Dr. Yang, thank you for your time and your insight.
