GI endoscopic submucosal dissection using a calibrated, small-caliber-tip, transparent hood for lesions with fibrosis

Post written by Tatsuma Nomura, MD, from the Department of Gastroenterology, Mie Prefectural Shima Hospital, Shima, and the Department of Gastroenterology, Ise Red Cross Hospital, Ise, Mie, Japan. We describe a novel technique for overcoming severe fibrosis encountered during endoscopic submucosal dissection (ESD) using a calibrated, small-caliber tip, transparent hood (CAST hood) with Pocket-creation method …

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Cholangioscopy-guided removal of a proximally migrated biliary stent using a modified standard polypectomy snare 

Post written by Moamen Gabr, MD, MSc, from the Division of Digestive Diseases and Nutrition, University of Kentucky, Lexington, Kentucky. A 72-year-old male with diagnosis of pancreatic head adenocarcinoma requiring endoscopic biliary stent placement 2 weeks prior to admission presented with signs of biliary obstruction. Imaging showed proximal migration of a previously placed biliary stent. …

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Active bleeding from downhill varices: case report and management

Post written by Aleem Azal Ali, MBBS, Sonal Jadeja, DO, and Bruno De Souza Ribeiro, MD, from the University of Florida, College of Medicine, Jacksonville, Florida, USA. This video manuscript describes the case of a 49-year-old man who presented in hypovolemic shock secondary to hematemesis. He had a similar presentation, 2 weeks prior, when EGD …

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Combination of a dynamic rigidizing overtube and a novel injectable needle-type knife to facilitate colorectal endoscopic submucosal dissection

Post written by Martin Coronel, MD, and Phillip S. Ge, MD, from the Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas. A 66-year-old man was referred for endoscopic resection of a 35-mm laterally spreading tumor at the hepatic flexure (Paris IIa+Is). A previous EMR attempt was unsuccessful …

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Cholangioscopy in primary sclerosing cholangitis: a case series of dominant strictures and cholangiocarcinoma

Post written by Sooraj Tejaswi, MD, MSPH, FASGE, from the Division of Gastroenterology & Hepatology, University of California Davis School of Medicine, Sacramento, California. This video case series describes and differentiates between the cholangioscopic features of benign dominant strictures and cholangiocarcinoma in PSC. It demonstrates that the morphologic features of cholangiocarcinoma in PSC is varied. …

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Endoscopic transcecal appendectomy under laparoscopic single-port assistance

Post written by Takashi Muramoto, MD, PhD, from the Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, Tokyo, Japan. We presented endoscopic transcecal appendectomy under laparoscopic single-port assistance for a flat-elevated tumor completely covering the appendiceal orifice in the video. The lesion was a flat-elevated tumor completely covering the appendiceal orifice, measuring 15 mm in …

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EUS-guided biliary rendezvous as an emergent rescue after failed choledochoduodenostomy using a lumen-apposing metal stent

Post written by Joan B. Gornals, MD, PhD, from the Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Catalonia, Spain. A 60-year-old man with pancreatic cancer and liver metastases who had been referred previously for biliary drainage was recommended palliative treatment. After a failed ERCP, same-session EUS-guided biliary drainage was …

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Step-by-step instruction: using an endoscopic tack and suture device for gastrointestinal defect closure

Post written by Andrew C. Storm, MD, from the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. In this video manuscript, we describe a step-by-step setup and use of a new endoscopic tool for tissue closure and fixation using the X-Tack device. X-Tack consists of a series of tacks on a suture that may …

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Evolution of re-epithelialization postcircumferential esophageal endoscopic submucosal dissection

Post written by Robert Bechara, MD, from the Queens University, Kingston Health Sciences Center, Kingston, Ontario, Canada. The introduction of endoscopic submucosal dissection (ESD) has revolutionized the management of superficial gastrointestinal neoplasia. In the esophagus, the stricture rate after a circumstantial ESD (cESD) without any prophylaxis medications is virtually 100%. There have been many reported …

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Underwater endoscopic mucosal resection of a rectal adenoma in the nondistensible rectum from severe fecal incontinence

Post written by Sukit Pattarajierapan, MD, from the Surgical Endoscopy Colorectal Division, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Our video presents a challenging case of difficult polypectomy in the nondistensible rectum from severe fecal incontinence. An 89-year-old woman with ischemic heart disease and hypertension underwent laparoscopic sigmoidectomy for stage II sigmoid …

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