ASGE Annual GI Advanced Practice Provider Course (Virtual) (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 prediction of POEM success

ERCP stent selection plastic versus metal

advanced GI endoscopy APP roles robotics transnasal endoscopy