Tack-only fixation of lumen-apposing metal stents: leave the suture at home

Post written by Andy Storm, MD, from Mayo Clinic, Rochester, Minnesota, USA. The availability of suture-based technologies is growing in flexible GI endoscopy, with one of the newcomers the X-Tack device (Boston Scientific, Marlborough, Mass, USA). This device, conceived with Dr Christopher Gostout and Apollo Endosurgery, uses steel “screws” or tacks that are drilled into …

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Retrograde device-assisted lumen-apposing metal stent insertion for candy cane syndrome

Post written by Anne Kimberly Lim-Fernandez, MD, from the Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore. Candy cane syndrome is an uncommon but clinically significant adverse event after gastric bypass or total gastrectomy. It arises when the long blind pouch at the anastomosis preferentially fills with ingested food. This can lead to symptoms …

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Circumferential endoscopic submucosal dissection of a 14-cm long-segment Barrett’s esophagus with multifocal adenocarcinoma: a case report

Post written by Kais Zakharia, MD, from the Division of Gastroenterology, University of Massachusetts Chan Medical School–Baystate Medical Center, Springfield, Massachusetts, USA. Barrett’s esophagus (BE) remains the only known precursor to esophageal adenocarcinoma and, although the risk of progression varies with segment length and degree of dysplasia, endoscopic management has increasingly replaced surgery in well-selected patients. In …

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Endoscopic combination therapy with photodynamic therapy and endoscopic resection for wide circumferential local recurrence after radiotherapy for esophageal cancer

Post written by Nobuhisa Minakata, MD, PhD, and Tomonori Yano, MD, PhD, from the Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan. We present the case of a patient who achieved local control with endoscopic combination therapy using photodynamic therapy and endoscopic resection for wide-circumferential local recurrence after radiotherapy for esophageal squamous cell carcinoma. In cases of …

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A novel anatomically guided strategy for evaluation of sufficient myotomy during peroral endoscopic myotomy in patients with achalasia

Post written by Ahmad Madkour, MD, from the Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Hassan Atalla, MD, from the Hepatology and Gastroenterology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, and Amr Elfouly, MD, from the Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt. We present a novel anatomically guided approach to assist experienced endoscopists in …

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Endoscopic resection of gastric subepithelial lesions: techniques and tips

Post written by Michael Lajin, MD, from Sharp HealthCare, San Diego, California, and Fateh Bazerbachi, MD, from CentraCare, St. Cloud, Minnesota, USA. This article presents the different endoscopic modalities for resecting gastric subepithelial lesions (SELs) including: Submucosal tunneling endoscopic resection Full-thickness resection using the gastric full-thickness resection device Endoscopic submucosal dissection Exposed endoscopic full-thickness resection Laparoscopic endoscopic cooperative surgery …

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Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue

Post written by Hiroki Hayashi, MD, from the Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan. EMR and endoscopic submucosal dissection are widely used for treating intramucosal gastric neoplasms. However, securing a clear visual field in a stomach with residue is challenging. In this article, we present 2 cases in which tumors …

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Minimizing bleeding risks during gastric neuroendocrine tumor endoscopic submucosal dissection by pre-emptive EUS-guided epinephrine injection

Post written by Radhika Chavan, MD, DNB, FISG, FASGE, from Bharati Vidyapeeth, Katraj, India. A 38-year woman presented with upper GI bleeding. During evaluation, it was detected she had a large subepithelial lesion in the midbody of the stomach. Further evaluation with EUS revealed a large hypoechoic lesion confined to the submucosa with a large …

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Endoscopic submucosal dissection for drainage of esophageal abscess with fish bone extraction

Post written by Abel Joseph, MD, and Joo Ha Hwang, MD, PhD, from the Division of Gastroenterology and Hepatology, Stanford University,  Stanford, California, USA. A 49-year-old woman with systemic lupus erythematosus and pulmonary hypertension presented with severe odynophagia after accidentally ingesting a fish bone. Initial CT imaging revealed linear density in the upper esophagus. Although an initial endoscopy did not identify …

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Endoscopic submucosal dissection in the management of bleeding duodenal tumors refractory to conventional therapy

Post written by Daryl Ramai, MD, MPH, MSc, from the Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA. A 94-year-old woman presented with melena and a significant drop in hemoglobin. Imaging with computed tomography revealed an intramural gastric antral mass extending into the proximal duodenum, and endoscopy demonstrated a large, bleeding pedunculated …

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