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Advancing flexible endoscopy to natural orifice transluminal endoscopic surgery
Purpose of review This review is an update on the recent advancements and clinical applications of flexible endoscopy in the context of natural orifice translumenal endoscopic surgery (NOTES). We focus on recent developments in gastrointestinal luminal and transluminal NOTES. Recent findings NOTES has evolved from a hybrid approach utilizing a laparoscopic assistant to pure NOTES without laparoscopic assistance. Current experimental and clinical studies focus on the implementation of new minimally invasive approaches as well as on the training in the use of these procedures. In recent years, flexible endoscopic-...
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Third space endoscopy: the future of treating gastrointestinal dysmotility
Purpose of review Third space endoscopy (TSE) or submucosal endoscopy provides with the opportunity for minimally invasive management of various gastrointestinal disorders. TSE is a relatively new field and the knowledge on its utility continues to advance. The purpose of this review is to provide with updated evidence on the efficacy and utility of TSE in gastrointestinal motility disorders including achalasia and refractory gastroparesis. Recent findings Peroral endoscopic myotomy (POEM) is a safe procedure with emerging evidence on its durability as well. Major technical variations do not appear to impact the...
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Interventional endoscopic ultrasound
Purpose of review To update on recent advances in interventional endoscopic ultrasound (INVEUS) techniques. Recent findings The introduction of linear echoendoscopes with larger instrument channels and the combined development of new tools and devices have enabled various new applications of minimally invasive endoscopic ultrasound (EUS)-guided transluminal interventions of the pancreas, biliary system and peri-gastrointestinal structures. In this review, EUS-guided interventions are discussed and evaluated: drainage of peripancreatic fluid collections, access and drainage of bile ducts, gallbladder and pancreat...
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Endoscopic approaches to gastroesophageal reflux disease
Purpose of review Gastroesophageal reflux disease (GERD) is one of the most common chronic conditions affecting adults. A substantial proportion of patients continue to have symptoms despite medical therapy, and there has been increased demand for minimally invasive GERD therapy. We will examine currently available techniques and outcomes data on endoscopic approaches to the treatment of GERD. Recent findings In the last 2 years, research has given rise to more robust understanding of not only the pathophysiology of GERD but also how to better manage the various phenotypes. We are learning the ideal patient to b...
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Tips for successful deep enteroscopy
Purpose of review The aim of this study was to provide practical tips to readers on how to perform deep enteroscopy efficiently. Recent findings Deep enteroscopy has revolutionized the diagnosis and management of small intestinal conditions in recent years. They are extremely valuable, but may be technically challenging to perform, regardless if it is double balloon enteroscopy, single balloon enteroscopy or spiral enteroscopy. The common issues to these procedures are repetitive motion, extended procedure duration and physical exertion during scope advancement. These situations may in turn lead to a variety of ...
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Updates in artificial intelligence in gastroenterology endoscopy in 2020
Purpose of review Artificial intelligence is becoming rapidly integrated into modern technology including medicine. Artificial intelligence has a wide range of potential in gastroenterology, particularly with endoscopy, given the required analysis of large datasets of images. The aim of this review is to summarize the advances of artificial intelligence in gastroenterology (GI) endoscopy over the past year. Recent findings Computer-aided detection (CADe) systems during real-time colonoscopy have resulted in increased adenoma detection rate with no significant increase in procedure times. Deep learning techniques...
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Incorporating image enhanced endoscopy in your everyday practice
Purpose of review The purpose of this review is to analyze newly available image enhanced endoscopic techniques and to evaluate how these techniques can be integrated into daily routine. Recent findings Recent guidelines have clearly stated how competency can be achieved. Endoscopist should have achieved general competence in endoscopy (more than 300 examinations) before commencing training in optical diagnosis. Summary A validated optical diagnosis training course should be attended and meeting competence thresholds by assessing a minimum number of lesions prospectively during real-time endoscopy should ...
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Single-use duodenoscopes: where are we and where are we going?
Purpose of review Given the growing concerns about infection transmission from use of contaminated reusable duodenoscopes, technological advancements have been made that vary from modifications of existing designs to development of single-use devices. Recent findings To circumvent mechanical limitations that preclude access to critical areas of a duodenoscope to perform thorough cleaning and disinfection, single-use disposable duodenoscopes have been developed. A thorough assessment of this technology is limited by the minimal published data that is currently available. This opinion assesses the current technica...
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Editorial: Recent advances in diagnostic and therapeutic endoscopy: moving towards the frontier
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - August 7, 2021 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Long-term outcomes of treatments for achalasia
Purpose of review Idiopathic achalasia is a primary motility disorder of the esophagus that results in dysphagia, weight loss, and impaired quality of life. Several treatment options are available to gastroenterologists, and insights on the long-term outcome of these modalities are discussed. Recent findings Peroral endoscopic myotomy (POEM) represents a novel endoscopic technique in the treatment of achalasia. Studies on long-term outcomes and comparison to other well-known treatment modalities such as laparoscopic Heller myotomy (LHM) and pneumodilation have recently been published. POEM and LHM both have exce...
Source: Current Opinion in Gastroenterology - June 17, 2021 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

Management of the patient with esophagogastric junction outflow obstruction
Purpose of review Esophagogastric junction outflow obstruction (EGJOO), defined as elevated integrated residual pressure (IRP) with preservation of esophageal peristalsis, is a common finding on high-resolution esophageal manometry. Recent findings The recent Chicago classification version 4.0 proposes changes to the criteria for diagnosing EGJOO, making this diagnosis more restrictive to now include elevated IRP in both supine and upright positions (with preservation of esophageal peristalsis), presence of obstructive symptoms, and confirmatory tests for EGJOO, such as timed barium esophagram with barium tablet...
Source: Current Opinion in Gastroenterology - June 17, 2021 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

The role of the allergist in the management of eosinophilic esophagitis
Purpose of review The purpose of this review is to provide the current understanding of the role of allergens/antigens, the use of allergy testing, and to elucidate the role of the allergist in the management of eosinophilic esophagitis (EoE). Recent findings EoE is a T2 immune disorder that is part of the atopic march. EoE patients commonly have multiple concurrent allergic disorders. Recent studies demonstrate that, like other allergic diseases, epithelial barrier dysfunction plays a key role in EoE pathogenesis. Aero- and food allergens have been identified as EoE triggers. EoE management includes the assessm...
Source: Current Opinion in Gastroenterology - June 17, 2021 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

The role of magnetic sphincter augmentation in the treatment of gastroesophageal reflux disease
Purpose of review Magnetic sphincter augmentation (MSA) has been designed as a less disruptive and more standardized laparoscopic surgical procedure than fundoplication for patients with early stage gastroesophageal reflux disease (GERD). We analyzed the more recent literature in search of updates regarding indications, technique, perioperative management, and long-term outcomes. Recent findings Over the years, the procedure of MSA has evolved to including full hiatus repair rather than relying on the preservation of the phreno-esophageal ligament. Restoring the mechanical synergy between the lower esophageal sp...
Source: Current Opinion in Gastroenterology - June 17, 2021 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

How extent of Barrett's metaplasia influences the risk of esophageal adenocarcinoma
Purpose of review This review will focus on how the extent of Barrett's metaplasia influences the risk of esophageal adenocarcinoma (EAC). More specifically, this review will discuss the concepts of long and short-segment Barrett's metaplasia and irregular Z line as they relate to EAC risk. Recent findings The Prague classification can standardize reporting of Barrett's metaplasia. Recent literature has found significant associations between the length of Barrett's metaplasia and increased progression risk to EAC in multiple geographically distinct populations. Length of Barrett's metaplasia has been incorporate...
Source: Current Opinion in Gastroenterology - June 17, 2021 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research