ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (On-demand) | May 2023-Session 1 Presentation 1

Video Transcription

Video Summary

In this video, Dr. Alan Barkin gives a lecture on new tools for non-variceal upper GI bleeding. He discusses two main modalities: endoscopically applied hemostatic topical products, particularly hemo spray, and cap-mounted clips, specifically over-the-scope clips. Dr. Barkin explains that non-variceal upper GI bleeding mortality has decreased to about 2% due to endoscopic hemostasis followed by PPI as an adjuvant. However, conventional endoscopic therapy can fail in 15% of cases, leading to the development of newer modalities. He discusses the different tools available for hemostasis, including bipolar electrocoagulation, heater probe, injection of absolute ethanol, through-the-scope clips, and soft monopolar electrocoagulation for GRASPR. Dr. Barkin then goes into detail about the use of hemostatic powders or gels, such as TC325 (hemo spray), endoclod, pyrostat, and Nexpowder. He also discusses the use of cap-mounted clips, specifically over-the-scope clips. He highlights the advantages and limitations of these modalities, as well as the available data and recommendations from guidelines. Dr. Barkin concludes by emphasizing the importance of optimizing the setting for endoscopic hemostasis and the need to collaborate with colleagues in challenging cases.

Asset Subtitle

Alan N. Barkun, MD, FASGE

Keywords

non-variceal upper GI bleeding

endoscopically applied hemostatic topical products

hemo spray

cap-mounted clips

over-the-scope clips