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SAGES Resident Resident Webinar : Work-up and Treatment of Achalasia-February 2017

 

Chair: Chair: Arghavan Salles, MD
Faculty: Prakash Gyawali, MD; Eric Pauli, MD; and William Richards, MD

Program Outline:
– Welcome and Overview – Arghavan Salles, MD
– Work-up of Achalasia – Arghavan Salles, MD
– Manometry and non-operative Management Options – Prakash Gyawali, MD
– Heller Myotomy – William Richards, MD
– POEM – Eric Pauli, MD

Achalasia diagnosis & work-up by Arghavan Salles–2:33

Pt presentation–2:56

Differential dx–3:40

Achalasia definition–5:57 Nat Rev Gastroenterol Hepatol 2011

Ann Gastroenterol 2015

Work-up–7:05

Eckardt score–8:57

Barium swallow–9:55

Upper endoscopy–10:33 Nat Rev Gastroenterol Hepatol 2015

High-resolution manometry–11:17

Chicago classification–12:38

Tx options–14:33

Achalasia: Manometry & non-operative management options by C. Prakash Gyawali–16:26

Achalasia overview–17:17

HRM plot–19:21 Gastroenterology 1994

Integrated relaxation pressure key determinant of EGJ transit–21:08 Neurogastroenterol Motil 2013

Failure of LES to relax–24:30 Neurogastroenterol Motil 2017

Histopathology in achalasia–25:55 Neurogastroenterol Motil 2016

2 pathways of inhibitory dyfunction–27:43 Gastroenterology 2013

Achalasia modern concepts–32:27 Neurogastroenterol Motil 2016

Clinical manifestations–35:15 J Gastrointest Surg 2015

Manometry: Hierarchial approach–36:26 Neurogastroenterol Motil 2015

Potential pitfalls & caveats–39:29 Gastrointest Endosc Clin N Am 2014

Impedance-pressure topography–41:02 Am J Gastroenterol 2014

Endo-FLIP in achalasia–42:03 Neurogastroenterol Motil 2013

Tx of achalasia & spastic disorders–44:39

Mechanism of action–44:58 Neurogastroenterol Motil 2011

Am J Gastroenterol 1999

Smooth muscle relaxants in achalasia & spastic disorders–47:53

Pneumatic dilation–49:40 Gut 2011

Therap Adv Gastroenterol 2013

Achalasia management options–51:22 Gastroenterology 2013

Curr Treat Options Gastroenterol 2014

Tx of achalasia–52:02 Am J Gastroenterol 2013

Summary–54:01

Heller/Dor for achalasia by William O. Richards–55:06

Rationale for Heller/Dor in achalasia–56:19

GERD after Heller or POEM impaired anti-reflux barrier–56:46

LES length & pressure are both important for an effective anti-reflux barrier–57:39

Mechanisms of GERD–59:33

Pertinent literature–59:55 Ann Surg 2004

J Gastrointest Surg 2016

Heller with Dor fundoplication–1:07:22

Procedural video clip–1:08:54

Conclusion–1:15:23

POEM by Eric M. Pauli–1:16:28

Why POEM?–1:18:38

Development of endoscopic myotomy–1:20:19 Gastrointest Endosc 1980

Technical refinement–1:22:50 Surg Endosc 2008

The 1st POEM–1:23:38 Endoscopy 2010

Technical steps–1:24:55 J Gastrointest Surg 2012

Technique changes–1:34:50

Post-op management–1:36:50

Complications–1:39:14

Results: Safety/efficiency–1:42:29 Surg Endosc 2015

Surg Endosc 2015 Orenstein SB

Results: Post-op issues–1:45:57 Surg Endosc 2017

Results: Durability–1:47:02 JACS 2015

Conclusion–1:47:31

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Video Uploaded By:
SAGES Webmaster
Uploaded on
03/29/2017
Video Categories
Webinar
Learning Themes
Academic / Educational
Sources
Resident Webinar
Presentation Types
How-To, Webinar
Video Tags
angle of His, antibiotics, antireflux surgery, aperistalisis, aspiration, autoimmune, balloon, barium swallow, bleeding, Botox, botulinum toxin, calcium channel blockers, chagas, chest tube, Chicago classification, clear liquids, CO2, corkscrew esophagus, crus, CXR, diaphragm, distensibility, Dor fundoplication, drainage, dysphagia, Eckardt score, EGD, EGJ, electrocautery, emergency surgery, Endo-FLIP, endoluminal surgery, endoscope, endoscopic clip, endoscopic management, endoscopic suturing device, endoscopy suite, endotracheal tube, eosinophilic, epinephrine, esophageal dysmotility, esophageal outflow obstruction, esophageal spasm, esophagectomy, esophagitis, esophagus, fever, fundus, gastroenterologist, gastroenterology, GEJ, general anesthesia, GERD, H&P, heart, heartburn, Heller myotomy, hiatal hernia, hiatus, HRM, imaging, impedance, incisors, indigo carmine, infection, IRP, leak, LES, malignancy, manometry, mediastinum, methylene blue, MIS, narcotics, natural orifice surgery, needle decompression, nitrates, nitroglycerine, opiods, Penn State Hershey Medical Center, perforation, pericardium, peristalsis, peritoneal cavity, pneumatic dilation, pneumonia, pneumothorax, POEM, polypectomy, PPI, pseudoachalasia, reconstruction, reflux, Resident Webinar, retroflexion, retrosternal chest pain, sclerosis, sclerotherapy, sigmoid esophagus, Sildenafil, stomach, stricture, surgical energy, surgical management, swallow study, tachycardia, tension pneumopericardium, thoracotomy, Toupet fundoplication, training, UGI, University of South Alabama College of Medicine, University of South Alabama Medical Center, upper endoscopy, vagus, Viagra, vomiting, Washington University, weight loss

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