Medical Reports & Case Studies

ISSN - 2572-5130

Endoscopic Treatment

Endoscopic therapy should follow the sequence of principle-technique-equipment/device. The key principles of endoscopic therapy are: (1) identification of a right patient, a right lesion and a right endoscopist in a right setting; (2) balance of risks and benefits of endoscopic vs alternative therapy (medical or surgical); and (3) keeping exit strategies in mind, such as endoscopic and surgical management of procedure-associated complications. Endoscopic therapy should be performed in an elective setting and emergent endoscopic therapy should be avoided. Endoscopic therapy should be avoided in patients with severe anemia, malnutrition or severe comorbidities, or on concurrent systemic therapy with corticosteroids and biologics. Pouch patients with concurrent primary sclerosing cholangitis (PSC) should be watched for procedure-associated bleeding due to the presence of portal hypertension, coagulopathy, or thrombocytopenia. EASIE uses resected stomachs of adult pigs which have been washed, and frozen. The stomachs are fastened to a board at six points, with the distal end of the esophagus attached to a tube that simulates the gastrointestinal tract. ERCP training can also be performed, in which case the stomach-duodenum-liver is preserved to allow for access to the bile ducts via the papilla. Current EASIE models include: hemostasis; polypectomy; APC; dilation; stent placement and ERCP. Endotrainer uses the same models, with some improvements.

Relevant Topics in Medical Sciences