Peroral endoscopic myotomy with diverticulotomy using a double tunnel technique: finding your way to an elusive lower esophageal sphincter in spastic achalasia and epiphrenic diverticulum

Post written by Maham Hayat, MD, and Dennis Yang, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. Our case is that of an 86-year-old woman with a history of achalasia and symptomatic epiphrenic diverticulum (ED) who was referred for peroral endoscopic myotomy (POEM) with simultaneous diverticulotomy. Endoscopy revealed a large ED and an …

Continue reading Peroral endoscopic myotomy with diverticulotomy using a double tunnel technique: finding your way to an elusive lower esophageal sphincter in spastic achalasia and epiphrenic diverticulum

Addition of dilute epinephrine to commercially available submucosal lifting agents for cold snare EMR

Post written by William Hirsch, MD, from the Division of Internal Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA, and Mohammad Bilal, MD, from the Division of Gastroenterology & Hepatology, Minneapolis VA Medical Center, University of Minnesota. Our video case details the process of adding dilute epinephrine to commercially available submucosa lifting agents. After …

Continue reading Addition of dilute epinephrine to commercially available submucosal lifting agents for cold snare EMR

Successful endoscopic removal of a retained guidewire in the intrahepatic bile duct using a novel tapered sheath dilator

Post written by Rintaro Fukuda, MD, and Naminatsu Takahara, MD, PhD, from the Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, and Yousuke Nakai, MD, PhD, from the Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo. Retained guidewire is not a rare adverse event …

Continue reading Successful endoscopic removal of a retained guidewire in the intrahepatic bile duct using a novel tapered sheath dilator

Definitive endoscopic repair of transected bile ducts after cholecystectomy using EUS-guided hepaticogastrostomy and retrograde cholangioperitoneoscopy

Post written by Manuel Perez-Miranda, MD, PhD, from Hospital Universitario Rio Hortega, Valladolid, Spain. A patient with a transected bile duct after cholecystectomy presenting with high-output bile leakage was successfully treated with staged endoscopy. EUS-guided hepaticogastrostomy was used first to internalize externally diverted bile flow. At a follow-up endoscopy, a cholangioscope by ERCP grasped a …

Continue reading Definitive endoscopic repair of transected bile ducts after cholecystectomy using EUS-guided hepaticogastrostomy and retrograde cholangioperitoneoscopy

Enhancing stent length and stability with a novel through-the-scope suturing platform: a case series

Post written by Shailendra Singh, MD, and Ayowumi A. Adekolu, MD, from West Virginia University, Morgantown, West Virginia, USA. We present a case series showing the use of a through-the-scope suturing (TTSS) system (X-Tack; Apollo Endosurgery, Austin, Tex, USA) for fixing 2 fully covered self-expandable metal stents (FCSEMSs) for creating longer stents as well as …

Continue reading Enhancing stent length and stability with a novel through-the-scope suturing platform: a case series

Endoscopic sleeve gastroplasty using mixed-tooth grasping forceps as an alternative to the tissue helix

Post written by Chase Wooley, BS, from True You Weight Loss, Cary, North Carolina, USA. In this video case, we demonstrate the advantages of using a mixed-tooth grasping forceps rather than the traditional tissue helix to acquire full-thickness gastric folds during the endoscopic sleeve gastroplasty (ESG) procedure. A customized animation highlights the risk of transmural tissue …

Continue reading Endoscopic sleeve gastroplasty using mixed-tooth grasping forceps as an alternative to the tissue helix

Retrograde endosonography for diagnosing imaging-occult cancer at the head of the pancreas in a patient with distal gastrectomy and Roux-en-Y reconstruction

Post written by Michael Lajin, MD, from Sharp HealthCare, San Diego, California, USA. A 73-year-old man with a history of distal gastrectomy presented with jaundice and 20-pound weight loss. Abdominal CT with intravenous contrast showed cholelithiasis and a dilated biliary tree without evidence of choledocholithiasis or neoplasm. MRCP was not possible because of shrapnel. He …

Continue reading Retrograde endosonography for diagnosing imaging-occult cancer at the head of the pancreas in a patient with distal gastrectomy and Roux-en-Y reconstruction

A modified approach for closing endoscopic submucosal dissection defects using clip with line pulley securing technique and endoloop

Post written by Yohei Minato, MD, from the Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, Tokyo, Japan. We modified the clip with line pulley suturing (CLiPS) technique using a plastic detachable snare. A clip with a string is placed at the distal margin of the mucosal defect. A second clip is then hooked onto …

Continue reading A modified approach for closing endoscopic submucosal dissection defects using clip with line pulley securing technique and endoloop

Closure in antireflux mucoplasty using anchor prong clips: dead space–eliminating technique

Post written by Kazuki Yamamoto, MD, PhD, from the Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan. This study features the dead space—eliminating technique (DET) as a novel closure method during antireflux mucoplasty (ARM-P) for proton pump inhibitor refractory—dependent GERD. Other techniques such as antireflux mucosectomy and antireflux mucosal ablation have shown effectiveness in meta-analyses, …

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Salvage endoscopic resection for perforation site recurrence of colonic polyp

Post written by Deepak Madhu, MD, MRCP, DM, from the Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, Tokyo, Japan. A 79-year-old patient underwent endoscopic submucosal dissection (ESD) for resection of a colonic polyp. The resection was complicated by an intraprocedural perforation, which an endoscopic omental patch closed. A surveillance endoscopy performed 1 year later showed …

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