ASGE Annual GI Advanced Practice Provider Course (On-Demand) - Onboarding (Day One)

Pdf Summary

Therapeutic endoscopy is a field that involves advanced procedures performed by specialized endoscopists. It is important to distinguish therapeutic endoscopy from diagnostic endoscopy, as therapeutic endoscopy involves more complex procedures. Some terms used interchangeably with therapeutic endoscopy include advanced endoscopy and interventional endoscopy.<br /><br />Becoming an advanced interventional endoscopist requires several years of medical school, internal medicine residency, gastroenterology/hepatology fellowship, and additional training in advanced endoscopy (AE). Alternative pathways may exist, and the content of AE fellowships may differ between programs.<br /><br />The resources and talent required to perform and deliver advanced endoscopy procedures include well-trained and experienced physicians, a team of trained nursing staff and technicians, support from anesthesia, surgery, oncology, radiology, and intervention radiology. Additionally, specialty endoscopes, large endoscopy suites, fluoroscope, and specialty electrosurgical generators are required.<br /><br />Some commonly performed advanced endoscopy procedures include ERCP, EUS, endoscopic resection (EMR, ESD, EFTR), endoscopic ablation, and enteral stenting. Examples of these procedures and their steps are shown in the document.<br /><br />The role of advanced practice providers (APP) in the advanced endoscopy team includes complex endoscopy referral triage, cognitive clinical assessment, shared clinic visits with the physician, independent clinic visits, peri-procedure support, follow-up management, interdisciplinary care coordination, and complication management.<br /><br />Skills required for an APP on the advanced endoscopy team include knowledge of clinical indications and relevant procedures, adherence to clinical practice guidelines, awareness of procedure contraindications, management of anticoagulant/antiplatelet agents, understanding the implications of altered GI anatomy, and identification and triage of procedure-related complications.<br /><br />Informed consent for advanced endoscopy procedures is crucial and is typically obtained by the performing physician or advanced fellows. APPs may be involved in scholarly activities and research in the advanced endoscopy field.<br /><br />The successful delivery of advanced endoscopy services requires collaboration between APPs and physicians, and APPs play an essential role in inter-disciplinary complex care management and patient communication. Ongoing mentorship and professional development of APPs are important in this field.

Asset Subtitle

Vivek Kaul, MD, FASGE

Keywords

Therapeutic endoscopy

Advanced endoscopy

Interventional endoscopy

Diagnostic endoscopy

ERCP

EUS

Endoscopic resection

Endoscopic ablation

Enteral stenting

Advanced practice providers