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

Video Transcription

Video Summary

The transcript captures a fast-paced Q&A with Caitlin, Sarah, and Vivek (with other physicians chiming in) on advanced GI endoscopy topics and APP roles. They explain prophylactic antibiotics for G-POEM/POEM are used because mucosal incision can introduce GI flora into the peritoneum; typical coverage is amoxicillin-clavulanate, or ciprofloxacin plus metronidazole for penicillin allergy. For achalasia, medical therapy is limited; calcium channel blockers may be tried but generally work poorly because achalasia is mechanical and also involves aperistalsis.<br /><br />On whether Botox response predicts POEM success, they note no clear correlation; prior interventions (Botox/balloons) may increase technical difficulty but usually don’t preclude POEM, and Botox trials may be more relevant in EGJ outflow obstruction.<br /><br />They discuss informed consent: usually done by the endoscopist, but institutional policies vary; legally, the consenter must understand indications/risks/benefits. ERCP stent choice (plastic vs metal) depends on benign vs malignant disease and desired durability; counsel patients that a stent and repeat procedures may be needed. Finally, they predict growing roles for APPs with robotics, clinic-based transnasal endoscopy, and evolving training and interdisciplinary workflows.

Keywords

POEM and G-POEM prophylactic antibiotics

Achalasia medical therapy calcium channel blockers

Botox response and POEM success prediction

ERCP stent selection plastic vs metal

Advanced practice provider roles in advanced endoscopy robotics transnasal endoscopy