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surgical intervention video

实时交互式手术：2型POEM贲门失弛缓症与偶发性食管平滑肌瘤


Chirurgie interactive live : technique POEM pour achalasie de type 2 et léiomyome œsophagien découvert fortuitement


POEM (peroral endoscopic myotomy) is an emerging procedure, which has evolved from the era of NOTES. The most cardinal indication for POEM is achalasia of the cardia. Other indications include diffuse esophageal spasm, jackhammer esophagus, and surgically failed cases. 

The steps of POEM include the following: mucosotomy, submucous tunnelling, myotomy, closure of mucosotomy. 

The myotomy is started 2 to 3cm distal to the mucosotomy and is continued to the end of the tunnel at 2 to 3cm distally to the gastroesophageal junction (GEJ). A partial myotomy is most commonly performed by means of careful dissection of circular fibers, hence avoiding longitudinal fibers to prevent entry into the mediastinum. The mucosotomy is then closed to prevent any leakage with the use of endoscopic clips or of an endoscopic suturing device. About the EndoFLIP™ (Endolumenal Functional Lumen Imaging Probe) Imaging System: this is a functional endoluminal imaging probe, which helps in the assessment of gastroesophageal junction distensibility and compliance after the procedure. 

Complications of POEM:

Inadvertent mucosotomy is the most common complication.

Complications due to insufflation (pneumomediastinum, pneumoperitoneum) can be controlled by using carbon dioxide for insufflation. Esophageal leak is the most dreaded complication with rates ranging from 0 to 5.6%. 



LIVE INTERACTIVE SURGERY: POEM for type 2 achalasia and incidental esophageal leiomyoma

CIRURGIA INTERATIVA AO VIVO: POEM para acalasia de tipo 2 e leiomioma esofágico incidental


CIRUGÍA INTERACTIVA EN VIVO: POEM para acalasia de tipo 2 y leiomioma esofágico incidental


LIVE-хирургия: пероральная эндоскопическая миотомия по поводу ахалазии пищевода 2 типа и случайно выявленной лейомиомы пищевода


实时交互式手术：食管胃十二指肠镜检查（EGD），色素内镜检查和BARRX治疗其余巴雷特的黏膜


Chirurgie interactive live : œsophagogastroduodénoscopie, chromo-endoscopie, et traitement BARRX de la muqueuse de Barrett restante


Chromoendoscopy is a procedure where dyes are instilled in the gastrointestinal tract at the time of visualization with endoscopy. It enhances the characterization of the tissues. The most common applications are as follows:

- Identification of squamous cell carcinoma or dysplasia;

- Identification of Barrett’s esophagus;

- Detection of early gastric cancer;

- Characterization of colonic polyps;

- Screening.

BARRX™ is a radiofrequency ablation of the metaplastic esophageal mucosa. The concept is to resect the epithelium and the muscularis mucosa without damaging the submucosa. It reduces the risk of developing carcinoma. 

LIVE INTERACTIVE SURGERY: Esophagogastroduodenoscopy (EGD), chromoendoscopy, and BARRX treatment of remaining Barrett's mucosa

CIRUGÍA INTERACTIVA EN VIVO: Esofagogastroduodenoscopia (EGD), cromoendoscopia y tratamiento por BARRX de la mucosa del Barrett remanente


LIVE-хирургия: эзофагогастродуоденоскопия, хромоэндоскопия и абляция остаточных зон пищевода Баррета с помощью системы BARRX


CIRURGIA INTERATIVA AO VIVO: Esofagogastroduodenoscopia (EGD), cromoendoscopia e tratamento por BARRX da mucosa do Barrett remanescente


Argon Plasma Coagulation (APC) is an innovative non-invasive endoscopic treatment used to reduce the anastomotic diameter. 

Technology: Argon gas is used to deliver evenly distributed thermal energy to a field of tissue close to the probe. The heat which is generated devitalizes, coagulates, desiccates, and shrinks the tissue. 

Argon Plasma Coagulation is performed by applications of 0.5 to 2 seconds in duration. The depth of penetration is around 2 to 3mm. 

Side effects: gaseous distension, pain, stricture, bleeding, pneumoperitoneum, and rarely perforation. 

LIVE INTERACTIVE SURGERY: Argon Plasma Coagulation (APC) pouch resizing after Roux-en-Y gastric bypass (GBP)

CIRURGIA INTERATIVA AO VIVO: Redimensionamento da bolsa por Coagulação com Plasma de Argônio (APC) após bypass gástrico em Y de Roux (BGYR)


Chirurgie interactive live : recalibration de la poche par coagulation au plasma argon après bypass gastrique


CIRUGÍA INTERACTIVA EN VIVO: Redimensionamiento de la bolsa por Coagulación con Argón Plasma (APC) después de bypass gástrico en Y de Roux (BGYR)


现场互动手术：氩离子凝固术（APC）囊大小在Roux-en-Y胃旁路术（GBP）


LIVE-хирургия: сужение просвета анастомоза после желудочного шунтирования по Ру с помощью аргон-плазменной коагуляции


Barrett’s esophagus is a metaplastic change in the lining mucosa of the esophagus in response to chronic GERD. The hallmark of specialized Barrett’s epithelium is mucus-secreting goblet cells (intestinal metaplasia). There is an increased risk of adenocarcinoma with intestinal metaplasia. BARRX™ is a new treatment option for Barrett’s esophagus which uses Radio frequency energy and minimizes the risk of developing cancer.

Radio frequency energy is delivered via a catheter to the esophagus, lasts less than a second and creates superficial injury to the mucosa.

Principle: To deliver high power (approx. 300 Watts) in a short period of time. This will allow the depth of penetration to ablate the epithelium and the muscularis mucosa without injuring the submucosa. Overall results are excellent with elimination of dysplasia in 80% of patients and stricture rate to less than 6%. 

Side effects: chest pain following the procedure, which can be treated with analgesics. 

Bleeding, infection, and perforation requiring surgery are some of the rare complications. 

Follow-up: endoscopy at 3 months and ablation repeated if required. 

LIVE INTERACTIVE SURGERY: Barrett's esophagus treatment using BARRX™ radiofrequency ablation (RFA) system

CIRURGIA INTERATIVA AO VIVO: Tratamento do esôfago de Barrett usando o sistema BARRX™ de ablação por radiofrequência (ARF)


实时交互式手术：巴雷特食管使用Barrx™射频消融（RFA）系统


Chirurgie interactive live : traitement de l'œsophage de Barrett avec ablation par radiofréquence BARRX


LIVE-хирургия: лечение пищевода Баррета с использованием системы радиочастотной абляции BARRX™


CIRUGÍA INTERACTIVA EN VIVO: Tratamiento del esófago de Barret utilizando el sistema BARRX™ de ablación por radiofrecuencia (ARF)


video lecture

Zenker’s diverticulum (ZD) is an abnormal hypopharyngeal pouch often presenting with dysphagia. Treatment is often sought with an invasive surgical management of the diverticulum. Nowadays, treatment is usually provided using a less invasive trans-oral technique with a rigid endoscope. In this authoritative lecture, Dr. Costamagna presents his technique and his experience.

Peroral treatment of Zenker's diverticulum (ZD)

O divertículo de Zenker (DZ) é uma bolsa hipofaríngea anormal que apresenta frequentemente disfagia. Em geral, o tratamento é realizado com manejo cirúrgico invasivo do divertículo. Mas, hoje em dia, está sendo utilizada uma técnica transoral menos invasiva com um endoscópio rígido. Nesta palestra de especialista, o Dr. Costamagna apresenta sua técnica e sua experiência.


Tratamento peroral do divertículo de Zenker (DZ)

Traitement oral du diverticule de Zenker


Gastric band erosion is one of the most dreaded complications of this bariatric procedure. Endoscopic removal of a migrated band seems to be an effective and safe method for band erosion. In this key lecture, Dr. Galvao Neto outlines his experience with this endoscopic treatment.

Endoscopic solutions to bariatric complications (endoscopic treatment of adjustable gastric band erosion)

A erosão da banda gástrica é uma das complicações mais temidas deste procedimento bariátrico. A remoção endoscópica de um banda migrada parece ser um método eficaz e seguro para a erosão da banda. Nesta palestra magistral, o Dr. Galvão Neto destaca sua experiência com este tratamento endoscópico.


Soluções endoscópicas para complicações bariátricas (tratamento endoscópico da erosão da banda gástrica ajustável)

Solutions endoscopiques aux complications bariatriques (traitement endoscopique de la dégradation d'un anneau ajustable)


Nesta palestra magistral, o Dr. Lee Swanström apresenta a abordagem endoscópica para estenoses, extravasamentos e fístulas benignas.


Estenoses, extravasamentos, fístulas e outros problemas: a endoscopia é a resposta

Sténoses, fuites, fistules et autres problèmes : l'endoscopie est la réponse


In this key lecture, Dr. Lee Swanström presents the endoscopic approach to benign strictures, leaks and fistulas.

Strictures, leaks, fistulas, and other problems: endoscopy is the answer

In this key lecture, Dr. Inoue outlines his large experience in endoluminal minimally invasive gastrointestinal procedures. 

Innovation and advances in endoluminal surgery

Nesta palestra magistral, o Dr. Inoue destaca sua vasta experiência com os procedimentos gastrintestinais endoluminais minimamente invasivos.


Inovação e avanços na cirurgia endoluminal

Innovation et avancées de la chirurgie endoluminale


In this key lecture, Dr. Rösch outlines the current results of some of the most performed endoscopic prcedures.

Long-term results of GI interventions

Nesta palestra magistral, o Dr. Rösch destaca os resultados atuais de alguns dos procedimentos endoscópicos mais realizados.


Resultados de longo prazo das intervenções GI

Résultats à long terme des interventions digestives


O bypass gástrico em Y de Roux (BGYR) é o padrão-ouro da cirurgia bariátrica. Contudo, um reganho de peso substancial representa uma grande preocupação no follow-up tardio. Nesta palestra magistral, o Dr. Galvão Neto define as indicações atuais para um procedimento adicional após o reganho de peso, bem como as diferentes abordagens endoscópicas disponíveis.


Revisão endoscópica do reganho de peso no BGYR

Roux-en-Y gastric bypass (RYGB) is the gold standard bariatric operation. However, substantial weight regain represents a major concern in late follow-up. In this key lecture, Dr. Galvao Neto defines the current indications for additional procedure after weight regain as well as the different endoscopic approaches available. 

Endoscopic revision of RYGB weight regain

Révision endoscopique d'un regain de poids après un pontage Roux-en-Y


Fuites et sleeve : stratégie endoluminale


Sleeve gastrectomy appears as an easy procedure. However, some complications are challenging to manage, and in particular postopertive fistulas. In this key lecture, Dr. Galvao Neto outlines the endoscopic options for treating this major complication.

Sleeve leaks: endolumenal strategy

A gastrectomia vertical parece ser um procedimento fácil. No entanto, algumas complicações são desafiadoras de lidar, particularmente as fístulas pós-operatórias. Nesta palestra magistral, o Dr. Galvão Neto destaca as opções endoscópicas para o tratamento desta complicação séria.


Focus On Flexible Gastrointestinal (GI) Endoscopy!