PERIAMPULLARY DUODENAL DIVERTICULUM ERCP INCIDENTAL FINDING AND ASSOCIATION WITH DIFFICULT BILIARY CANNULATION. A CASE SERIES.
Carlos M Zavaleta, MD, Fernando A Quesada, MD. IntergastroIntroduction: A classification for Periampullary Duodenal Diverticulum (PAD) was proposed by Boix et al in three types based on location. These anatomical variants may require more expertise from endoscopist in charge to achieve a successful procedure as it has been reported as a factor associated with difficult biliary… Continue Reading
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PERCUTANEOUS ENDOSCOPIC GASTROSTOMY IN AMYOTROPHIC LATERAL SCLEROSIS PATIENTS: OUTCOMES OF A DEDICATED SURGERY AND ANESTHESIA PROTOCOL
David J Morrell, MD1, Marvin H Chau, BS2, Vamsi V Alli, MD1, Elizabeth H Sinz, MD1, Sprague W Hazard, MD1, Zachary Simmons, MD1, Eric M Pauli, MD1. 1Penn State Health Milton S. Hershey Medical Center, 2The Pennsylvania State University College of MedicineIntroduction: Patients requiring percutaneous endoscopic gastrostomy (PEG) for amyotrophic lateral sclerosis (ALS) related dysphagia… Continue Reading
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Percutaneous Endoscopic Gastrojejunostomy Tube Placement: A Technique Using a Tapered Dilator within a Peel-away Sheath
Jaclyn Clark, MD, Lindsay O'Meara, CRNP, Jose J Diaz, MD. University of MarylandIn patients with gastric dysfunction who require nutritional support, jejunal feeding is a safe method for providing enteral nutrition. There are several approaches to place gastrojejunostomy (GJ) tubes, including percutaneous, open, radiologically-guided, endoscopic and various combinations of the above. It can often be… Continue Reading
OVER-THE-SCOPE CLIP MANAGEMENT OF NON-ACUTE, FULL-THICKNESS GASTROINTESTINAL DEFECTS
David J Morrell, MD1, Joshua S Winder, MD1, Ansh Johri, MS2, Vamsi V Alli, MD1, Eric M Pauli, MD1. 1Penn State Health Milton S. Hershey Medical Center, 2The Pennsylvania State University College of MedicineIntroduction: Given the morbidity of reoperation, endoscopic management of full-thickness gastrointestinal tract defects (FTGID) has become an attractive management strategy. We have… Continue Reading
NOVEL ROBOTIC TRANSANAL APPROACH TO EARLY RECTAL NEOPLASIA: A SINGLE SURGEON’S EXPERIENCE WITH THE MEDROBOTICS FLEX*TM COLORECTAL DRIVE
Ada E Graham, MD, Natalie Pudalov, Vincent Obias, MD. George Washington University HospitalIntroduction: Treatment for early rectal cancer has evolved from the total mesorectal excision with data to support local excision. The nonlinear anatomy of the rectum and distal colon make surgical access and visualization of these regions challenging given the linear nature of most instrumentation… Continue Reading
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Modification of Child Pugh Score Improves Prognostication in Variceal Bleeding
Richard T Spence1, Jake Krige2, Marius Hoogerboord1, James Ellsmere1. 1Dalhousie University, 2University of Cape TownBackground: There is currently no consensus which specific risk factors or scores predict early rebleeding and early mortality after a major variceal bleed. The objective of this study was to investigate the relative predictive performances of the Child-Pugh and MELD scores for… Continue Reading
Minimally Invasive Surgery: Colonoscopic Assisted Transanal Endoscopic Microsurgery for Local Resection of a Large Sigmoid Polyp
Kevin M Izquierdo, MD, Beverly Ng, MD, John H Marks, MD. Lankenau Medical CenterThis video demonstrates a novel approach to perform endoluminal surgery for a 3cm polyp in the distal sigmoid colon using a combined rigid and flexible endoscopic approach. The patient is a 56-year-old male who presented with symptoms of intermittent rectal bleeding for… Continue Reading
Management of various rectal lesions by using TAMIS.
Pramod Nepal, MD, Shinichiro Mori, MD, PhD, Yoshiaki Kita, MD, PhD, Kan Tanabe, MD, PhD, Kenji Baba, MD, PhD, Yasuto Uchikado, MD, PhD, Hiroshi Kurahara, MD, PhD, Takaaki Arigami, MD, PhD, Masahiko Sakoda, MD, PhD, Kosei Maemura, MD, PhD, Shoji Natsugoe, MD, PhD. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine,… Continue Reading
Laparoscopic-assisted Percutaneous Endoscopic Gastrostomy (PEG) tube placement in patient with unsuccessful attempt of PEG
Usah Khrucharoen, Greg Sacks, Yijun Chen, Erik P Dutson. UCLAIn this video, we demonstrated a technique of laparoscopic-assisted PEG tube placement in patient with unsuccessful attempt of PEG due to air-filled loops of colon positioned between the stomach and anterior abdominal wall. In this case, patient had a history of recurrent embolic strokes and swallowing disorder… Continue Reading
IS IT TIME FOR GENERAL SURGEONS TO PLACE WIRELESS pH PROBE AT THE TIME OF INITIAL ENDOSCOPY FOR PATIENTS WITH GASTROESOPHAGEAL REFLUX SYMPTOMS?
Medhat Fanous, MD, FACS, Anja Jaehne, MD, Amanda Lambert, RN, David Lorenson, RN. Aspirus Iron River HospitalIntroduction: Patients with symptoms of Gastroesophageal reflux disease (GERD) are often given a trial of proton pump inhibitors (PPIs). Despite low diagnostic yield, esophagogastroduodoscopy (EGD) is usually offered when empiric treatment fails. When a pH study is warranted to confirm… Continue Reading
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Intraoperative Endoscopy; A Safe and Valuable Tool for the Diagnosis and Treatment of Midgut Pathology
Amanda Fazzalari, MD1, Shruthi Srinivas, BS1, Natalie Pozzi, MD2, Christopher Schlieve, MD1, Jonathan Green, MD1, Demetrius Litwin, MD, MBA, FACS1, David Cave, MD, PhD1, Mitchell Cahan, MD, MBA, FACS1. 1University of Massachusetts, 2Saint Mary's HospitalObjective: Intraoperative endoscopy (IOE) was first described in the late 1960s and is regarded as the gold standard for complete evaluation of… Continue Reading
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Imaging through blood super-resolution based flexible micro-endoscope
Omer Wagner, PhD1, Asaf Shahmoon, PhD1, Zeev Zalevsky, Prof2. 1Z square, 2Bar Ilan UniversityObjective of the technology: The recent development of micro-endoscopic imaging tools opened a new door of medical modalities and opportunities of capturing images in a minimally invasive way. The main still remaining problem is that although the micro-endoscope can reach close to the… Continue Reading
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HEALTH ECONOMIC SAVINGS OF SINGLE USE FLEXIBLE ENDOSCOPES VS CURRENT RE-USABLE ENDOSCOPES AND DISPOSABLE SHEATH SYSTEMS
Deepak Kumar Sahu, MBA1, Giacomo Basadonna, MD, PhD2. 1Alira Health, 2University of Massachusetts Medical SchoolIntroduction: The transmission of endoscopy-associated infections is frequently linked to inadequate reprocessing. Regulatory organizations including FDA have published reprocessing guidelines resulting in an increase of associated time and costs. Flexible single use endoscopes represent the solution to complex re-processing procedures and… Continue Reading
Giant Rectal ESD With Tissue Retraction: A Unique Approach
Sam K Sharma, James E East, Adam A Bailey. Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, U.K.INTRODUCTION: Hypothesis: The use of a novel endoscopic tissue retraction device was 1) feasible and 2) facilitated effective and efficient dissection of giant colonic polyps. Giant colonic polyps (>4cm diameter) are often treated by surgical resection. Endoscopic treatment options… Continue Reading
Gastric Per Oral Pyloromyotomy for Post-Vagotomy Induced Gastroparesis Following Esophagectomy
Megan Sippey, MD, Mark Anderson, MD, Jeffrey Marks, MD, FASC, FASGE. Case Western Reserve UniversityIntroduction: Delayed gastric emptying occurs in approximately 15-30% of patients following thoracoabdominal esophagectomy. This is predominantly due to inherent vagotomy. Patients have a decreased quality of life secondary to persistent nausea and intolerance of oral intake. Management options include dietary modifications,… Continue Reading