Endoscopic peroral pyloromyotomy (pop/g-poem) shows superior outcomes compared to laparoscopic gastric electrical stimulation (ges) for treating medically refractory gastroparesis.

• Mean operative time was significantly shorter for pop/g-poem (28.9 minutes vs 95.6 minutes, p < 0.001).
• Length of stay was reduced with pop/g-poem (0.5 days vs 2.4 days, p < 0.001) and it had a lower symptom recurrence rate (41.6% vs 78.8%, p < 0.001).

Consider pop/g-poem as the first-line surgical option for better efficacy and reduced morbidity in gastroparesis patients.