Digestive Disease Week 2022 – Cutting-Edge Developments in Endoscopic Procedures.

In my continuing coverage of DDW 2022 I attended a lecture on May 22, 2022
titled “ASGE Presidential Plenary: An Update for All Endoscopists.

This lecture intrigued my interest. Below is a summary of information presented at this lecture as well as other sources. I was able to reach out to both Dr. Douglas Rex and Dr. Bret Peterson.

KEY TAKEAWAYS

• Present-day cutting-edge developments in endoscopic procedures: The state-of-the-art trends in endoscopic procedures have changed greatly over time and now include the following:

• High-definition imaging technology: This improves diagnostic and treatment options by enabling a better visualization of the gastrointestinal system.

• Therapeutic endoscopy: Endoscopic procedures now include therapeutic interventions such the excision of polyps, the implantation of stents, and the management of bleeding.

• Endoscopic ultrasound: With the help of this procedure, doctors can stage cancers more effectively and perform targeted biopsies by obtaining high-resolution images of the gastrointestinal tract and surrounding organ.

• Artificial intelligence: By utilizing artificial intelligence, cutting-edge real-time image analysis algorithms have been developed, enabling more precise diagnosis and treatment planning.

• Minimally invasive endoscopy: This category covers operations that try to reduce the invasiveness of endoscopic procedures, such as single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery.

Endoscopic submucosal dissection and endoscopic mucosal resection:Endoscopic procedures called EMR and ESD are used to remove gastrointestinal lesions like polyps and early stage malignancies. The size, location, and form of the lesion determine whether to use EMR or ESD.EMR is a less complicated method that is frequently applied to minor, noninvasive lesions. For enbloc resection of bigger tumors, especially those with submucosal invasion, ESD is a more intricate procedure. ESD has the advantage of achieving complete resection and lowering the likelihood of recurrence. But it’s a complicated process that calls for a lot of technical knowledge.

Endoscopic resection defect closure: To avoid complications like bleeding and perforation, it’s crucial to seal the defect left behind after an EMR or ESD. Endoscopic clips, sutures, and over-the-scope clips (OTSC) are all possible methods of closure. The size, location, and endoscopist’s level of experience all play a role in the closure method selection. The complete closure of larger faults is made possible by the more recent approach known as OTSC, which has demonstrated encouraging outcomes in numerous investigations.

G-POEM and POEM: Endoscopic procedures used to treat achalasia and other esophageal motility abnormalities include gastric per-oral endoscopic myotomy (G-POEM) and per-oral endoscopic myotomy (POEM). Candidates should go through a thorough evaluation to establish the diagnosis and rule out any other possible sources of symptoms because patient selection is crucial for success. Identification of the gastroesophageal junction, construction of a submucosal tunnel, and myotomy of the circular muscle fibers are important technical performance phases. The endoscopist’s skill and cautious patient selection are crucial to the success of G-POEM and POEM.

Richard Berk is a staff reporter and executive producer for Utah Channel 3. Richard’s focus is on medical technology and new techniques/procedures with a focus on Type 1 and Type 2 diabetes. Richard is a member of several medical associations and also gives back to the medical community by sponsoring medical lectures. Richard is also a regular contributor to TechTalk.