ASGE Annual GI Advanced Practice Provider Course (Virtual) (Day One) | March 2026-Therapeutic Endoscopy Fundamentals for APPs

Pdf Summary

This ASGE APP Course overview defines therapeutic/advanced/interventional endoscopy as endoscopic procedures that go beyond diagnosis to deliver intervention, a field that began with colonoscopic polypectomy (1960s) and ERCP with sphincterotomy (1970s) and now includes a broad 2025-era portfolio such as EUS, ERCP, third-space endoscopy, endoscopic resection, bariatric endoscopy, stenting, and ablation. It outlines the typical physician training pathway (medical school, internal medicine residency, GI fellowship, plus 1–2 years of advanced endoscopy fellowship), noting variability in curricula, lack of ACGME accreditation, and no formal subspecialty certification yet.<br /><br />Common advanced procedures listed include ERCP, EUS, deep enteroscopy, endoscopic ablation (RFA/cryotherapy), EMR, ESD, EFTR, POEM, enteral stenting, bariatric endoscopy, and complex “endosurgical” interventions (e.g., pseudocyst drainage, necrosectomy, gastrojejunostomy creation). Delivering these services requires substantial infrastructure: specialized scopes and devices, large procedure suites, fluoroscopy (ideally in-unit), and electrosurgical generators, plus a coordinated multidisciplinary team (expert physician, trained nurses/techs, anesthesia, surgery, oncology, radiology/IR).<br /><br />A major focus is the APP role on an advanced endoscopy team: referral triage; pre- and post-procedure clinical assessment; shared and independent clinic visits; day-of-procedure support; results follow-up; coordination across specialties; and assistance with complication recognition and management. Required APP knowledge includes indications/contraindications, guideline-based care (e.g., avoiding ERCP for SOD type III), peri-procedural anticoagulant/antiplatelet management, and considerations in altered anatomy (e.g., ERCP after Roux-en-Y gastric bypass). The document emphasizes meticulous informed consent due to higher complication and litigation risk (typically obtained by the proceduralist MD), and highlights opportunities for APP scholarly activity in a rapidly evolving, device-driven field.

Asset Subtitle

Sarah Enslin, PA-C, and Vivek Kaul, MD, FASGE

Keywords

therapeutic endoscopy

advanced endoscopy

interventional endoscopy

ERCP

EUS

third-space endoscopy

endoscopic mucosal resection (EMR)

endoscopic submucosal dissection (ESD)

peroral endoscopic myotomy (POEM)

advanced practice provider (APP) role