Post written by Marc Julius H. Navarro, MD, from the Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan, the Institute of Digestive and Liver Diseases, St. Luke’s Medical Center, Quezon City, and the Department of Medicine, Section of Gastroenterology, Makati Medical Center, Makati, Philippines.

Endoscopic interventions require precise control of the endoscope tip. Inadequate angulation occurs with many clinically used endoscopes because of wear and tear, possibly impeding procedural effectiveness. Research indicates that a substantial percentage of endoscopes are not optimally tuned to reach the maximal bending angles that manufacturers specify, leading to difficulties in procedures requiring precise control of the tip.

This video case presents a novel approach to enhancing the angulation capabilities of therapeutic endoscopes through a handmade snare-assisted endoscope tip-bending angulation booster. This technique addresses the common issue of inadequate angulation in endoscopy.

This article is significant for several reasons, particularly in the context of improving endoscopic procedures and responding to common challenges practitioners face. This case offers a practical solution to enhance endoscope angulation, which is crucial for successful interventions such as gastric endoscopic submucosal dissection in retroflexed position and antireflux mucosal ablation and antireflux mucosectomy procedures for endoscopic antireflux therapy.

The Original Article highlights its application in real clinical scenarios involving patients with proton pump inhibitor–refractory GERD for endoscopic antireflux therapy. The use of the angulation booster allowed for improved visibility and precision during antireflux mucosal ablation and antireflux mucosectomy. This practical demonstration underscores the potential for better patient outcomes through enhanced procedural techniques.

Given that inadequate tip responses can delay procedures and reduce inspection quality, showcasing this technique answers a critical need in endoscopy practice. The video emphasizes how such innovations can mitigate these issues, ultimately enhancing the quality of patient care. In summary, this video is crucial, as it not only addresses a prevalent issue in endoscopic practice but also gives a straightforward solution that can be readily implemented to improve procedural outcomes.

The angulation booster is described as simple, quick, cheap, effective, and reproducible. This accessibility makes it an appealing option for many healthcare facilities, especially those that may lack access to advanced or specialized equipment. By displaying this method, the video provides a valuable resource for practitioners looking to improve their procedural capabilities without incurring significant costs or downtime. However, it is important to note that this method is not manufacturer-approved and may void warranties associated with the equipment used.

Proper angulation booster technique.

Read the full article online.

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