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

Pdf Summary

This document provides a comprehensive overview of colonoscopy, prepared by Dr. Sumeet K. Tewani, and outlines the procedure's various phases, patient selection criteria, potential complications, and the role of artificial intelligence. Key highlights include:<br /><br />**Pre-Procedure Phase:** <br />Indications for colonoscopy range from screening and surveillance to addressing lower gastrointestinal bleeding, abnormal imaging, and chronic conditions like diarrhea. It emphasizes patient selection where procedural results can significantly alter patient management, and highlights situations where risks may outweigh benefits, such as suspected perforation or fulminant colitis. Proper patient preparation is crucial, involving diet modifications, medication adjustments, and obtaining informed consent.<br /><br />**Intra-Procedure Phase:**<br />The procedure involves performing a high-quality exam with considerations for cecal intubation rates and adenoma detection. Choosing the appropriate scope and devices for biopsy or polyp removal is essential. Diagnostic and therapeutic maneuvers include tissue sampling, polypectomy, endoscopic hemostasis, and colonic decompression.<br /><br />**Complications:** <br />While serious complications are rare, cardiopulmonary issues related to sedation are most common. Measures to minimize these risks include thorough anesthesia assessments. Immediate concerns post-polypectomy include bleeding, managed through various interventions like epinephrine injections or hemostatic clips, and potential perforations from mechanical or electrocautery injuries.<br /><br />**Post-Procedure Phase:** <br />Post-procedure involves discussing findings, medication management, and ensuring pathology results follow-up. Quality indicators stress the importance of documentation, adequate bowel preparation, and tracking adverse events like post-polypectomy bleeding and perforation rates.<br /><br />**Artificial Intelligence:** <br />AI systems aid in the detection and classification of colorectal polyps and adenomas, highlighting a potential real-time value although facing financial challenges.<br /><br />Overall, the presentation underscores the importance of each procedural phase, the careful selection of patients, and the integration of AI to improve outcomes while minimizing risks.

Asset Subtitle

Sumeet K. Tewani, MD, FASGE

Keywords

colonoscopy

artificial intelligence

pre-procedure phase

intra-procedure phase

complications

post-procedure phase

patient selection

polypectomy

anesthesia assessment

adenoma detection