monthly focus

video lecture

In this key lecture, Dr. Inoue focuses on endoscopic mucosal resection (EMR) with a series of questions and answers. 

Endoscopic treatments for reflux disease: ARMS and ARMA

Mucosectomie endoscopique (ME) et dissection sous-muqueuse endoscopique (DSM)

эндоскопическая резекция слизистой (EMR) и эндоскопическая подслизистая диссекция (ESD)

In this key lecture, Dr. Inoue focuses on peroral endoscopic myotomy (POEM) for esophageal achalasia. 

POEM for esophageal achalasia 

POEM по поводу ахалазии кардии

Myotomie per-orale endoscopique (POEM) pour achalasie œsophagienne

In this key lecture, Dr. Yahagi focuses on endoscopic submucosal dissection (ESD).

Indications and techniques of endoscopic submucosal dissection (ESD)

Показания и техники выполнения эндоскопической подслизистой диссекции (ESD)

Dissection sous-muqueuse endoscopique (DSM) : indications et techniques

In this key lecture, Dr. Yahagi focuses on the prevention and treatment of complications. 

Prevention and treatment of complications

Предотвращение и лечение осложнений

Prévention et traitement des complications

Myotomie gastrique per-orale endoscopique (G-POEM)

Пероральная эндоскопическая миотомия желудка (G-POEM)

In this key lecture, Dr. Barthet focuses on Gastric Peroral Endoscopic Myotomy (G-POEM).

Gastric Peroral Endoscopic Myotomy (G-POEM)

surgical intervention video

A 59-year-old woman was referred to our unit for progressive dysphagia and chest pain associated with heartburn and chest fullness. A nutcracker esophagus was suspected at the HD manometry and the patient was scheduled for a peroral endoscopic myotomy (POEM). The procedure started with an esophagogastroduodenal series (EGDS), which showed abnormal contractions of the distal esophagus and increased resistance at the level of the esophagogastric junction (EGJ) with a high suspicion of type III achalasia. The tunnel was started 12cm above the EGJ in a 5 o’clock position. After submucosal injection, a mucosal incision was made with a new triangle-tip (TT) knife equipped with water jet facility. The access to the submucosa was gained and a submucosal longitudinal tunnel was created until the EGJ, dissecting the submucosal fibers with the TT knife. The myotomy was performed by completely dissecting the circular muscular layer muscle fibers using swift coagulation. To assess the extension of the myotomy just at the level of the EGJ, a “double scope control” was performed by inserting a pediatric scope, which confirmed the presence of the mother scope light in the esophagus. The submucosal tunnel and the myotomy were then extended together for 1 to 2cm. A second check with the pediatric scope showed the presence of the mother scope light in the correct position above the EGJ. The mucosal incision site was finally closed using multiple endoclips. 

Peroral endoscopic myotomy of a suspected type III achalasia with a double scope control 

Пероральная эндоскопическая миотомия по поводу подозрения на ахалазию III типа 

Myotomie per-orale endoscopique pour suspicion d’achalasie de type III avec double contrôle endoscopique

Sleeve gastroplastie endoscopique : intervention live

Endoscopic sleeve gastroplasty is a novel endobariatric procedure with a mechanism of action totally different from the one used for a standard sleeve gastrectomy. An over-the-scope suturing system mounted on a dual-channel Olympus® scope allowed to place full-thickness sutures in order to reduce the volume and the size of the stomach. The procedure was performed with the patient under general anesthesia and carbon dioxide insufflation. Once the Overtube™ was placed, the scope equipped with the OverStitch™ (Apollo Endosurgery®, Austin, Tex) suturing device was inserted through the stomach, and the suturing was initiated at the level of the incisura. The tissue-retracting helix device was used to grab the stomach wall, allowing for full-thickness bites. Each suture consisted of multiple sequential U-shaped bites along the anterior wall, the greater curvature, the posterior wall, and then in the opposite direction. Once completed, the suture was tied and knotted using a cinching device. Three sutures were applied in order to obtain gastric tubulization, and to spare the fundus.

Endoscopic sleeve gastroplasty: live procedure

Эндоскопическая рукавная гастропластика: LIVE

Эндоскопическая резекция слизистой (EMR) гиперпластического полипа желудка

Mucosectomie endoscopique (ME) de multiples polypes gastriques hyperplasiques

A 69 year-old man with a history of hypertension, type 2 diabetes, and renal insufficiency underwent a gastroscopy for chronic anemia. During this procedure, a 3cm hyperplastic gastric polyp was discovered. The patient was scheduled for endoscopic submucosal dissection (ESD). The procedure started with a gastroscopy, which showed a normal duodenum and many gastric hyperplastic polyps. The largest one was a pedunculated polyp of about 3cm in size at the level of the greater curvature. The operator opted for endoscopic mucosal resection (EMR) of the multiple polyps. After submucosal injection, polyps were resected using a snare (ENDO CUT® Q mode). All resected polyps were retrieved with a Roth Net® for histological evaluation.

Focus on GI endoscopy