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

Pdf Summary

This document provides an overview of colonoscopy, including patient selection, pre-procedure preparation, the procedure itself, potential complications, post-procedure care, and the role of artificial intelligence (AI) in colonoscopy.<br /><br />Colonoscopy is the only screening test that can detect and remove polyps in the same setting. Delayed post-polypectomy bleeding most commonly occurs between 5-7 days.<br /><br />Patient selection for colonoscopy is important, as it can change patient management and serve as an alternative to radiology. Indications for colonoscopy include screening, surveillance, lower gastrointestinal bleeding, abnormal imaging, diarrhea, and therapeutic intervention.<br /><br />Pre-procedure preparation involves timely scheduling, contraindications, clear liquid diet, low residue diet, medication management, informed consent, and bowel preparation. Sedation assessment is necessary to ensure a high-quality exam, proper cecal intubation rates, withdrawal times, and adenoma detection rates.<br /><br />During the procedure, colonoscopes of different types are used based on patient factors. Tissue sampling, polypectomy, tattooing, endoscopic hemostasis, dilation, and colonic decompression may be performed.<br /><br />Complications of colonoscopy are generally low, with cardiopulmonary complications related to sedation being the most common. Immediate post-polypectomy bleeding and perforation are potential complications, but epinephrine injection, hemostatic clips, thermal therapy, and prompt management can help mitigate them.<br /><br />Post-procedure care involves disseminating findings to patients, addressing medications, and following up on pathology results. Participating in quality databases, achieving high adenoma detection rates, cecal intubation rates, and low post-polypectomy bleeding and perforation rates are important quality indicators.<br /><br />AI has the potential to assist in decision support systems, detecting and classifying colorectal polyps and adenomas in real time. However, financial challenges and the need to balance the role of AI with gastroenterologist shortages should be considered.<br /><br />In conclusion, understanding the different phases of colonoscopies, patient selection, complications, and the potential role of AI can improve the overall management and outcomes of patients undergoing colonoscopy.

Asset Subtitle

Joseph Vicari, MD, MBA, FASGE

Keywords

colonoscopy

patient selection

pre-procedure preparation

procedure

complications

post-procedure care

artificial intelligence

polyps

screening

surveillance