Good morning, I'm Norio Fukami, I'm at Medical Clinic Arizona, I'm one of the course directors, together with Dr. Naohisa Ihagi. And I want to sincerely welcome you for this course, we'll go over the course in a minute but we would like to first describe this course, what it's going to be. This is really aimed for one-on-one, hands-on, for as long as the hands-on we can do. So you're going to be only one person at the station and you're going to have one teacher for the whole duration of time. So please think about what you really want to learn, what you want to focus on, and ask them the questions and they will give you the exact teaching what you want. So this is a tailored, personalized course. It is the first of a kind in this very small group of people, we have a total of 15 today. So could you raise your hand, participants, all the participants? Good, perfect, it's in the center. All right, welcome. Any of you brought a video at all? Shame on you. You did? Okay, well, we'll kick start our faculty video and if you want to share, there's another session tomorrow. And welcome to the virtual audience as well, thank you for joining us. And please, we'll go over, but you're always welcome to ask questions. First we would like to sincerely apologize, Dr. Inoue couldn't come this time because of the sickness. He had to have minor surgery, oral surgery, so he's going to be missing being here. And also Dr. Yamamoto, Hironori Yamamoto was supposed to be here but he couldn't come because of the prior engagement. So hopefully you get to meet them in the future courses. Now let me introduce my esteemed co-director, Dr. Naoisei Ahagi, and please welcome and we'd like to have some of the greetings. Thank you, Naoisei. Thank you. Good morning, everybody, and welcome to this wonderful ESD training course this year. This is a really unique opportunity because, as Norio mentioned, you can have really one-on-one hands-on training throughout the course. As everybody knows, ESD is a unique technique, high-end therapeutic endoscopy procedure, which we can achieve reliable unblock resection even for the really big and difficult region. But at the same time, it is quite time-consuming, sometimes even risky, so you should know the details of the technique. Fortunately, we have lots of experts who are doing lots of ESD coming from Japan and also coming from around the United States. I'd like to introduce our Japanese colleagues, Dr. Saito from National Cancer Center. He's an inventor of IT nano, and Dr. Takashi Toyonaga, who is coming from Kobe University, and he is an inventor of a flash knife, and of course, I invented lots of ESD devices. And Dr. Mayo Tanabe from Showa University, currently she is working together with Professor Haru Inoue. So she is not only an expert for ESD, but also for poem techniques, therefore, if you have any question, even for the poem, you can ask directly to her. And Dr. Seiichiro Abe from National Cancer Center, working together with Yutaka, and he is also a very skillful guy, and serving as associate editor of GIE. So if you have some question regarding the publication from GIE, you can ask him. And Dr. Miura coming from Jiji University, and he is working together with Dr. Yamamoto, and he is a pioneer of pocket creation method, which is kind of natural traction technique. So if you have any question, please feel free to ask him. And Dr. Daisuke Kikuchi, coming from Toronto Hospital, previously, I had a chance to work together at Toronto Hospital, so he already know my technical tips and all the secrets, so please feel free to ask him. And Dr. Sasaki from Kagoshima University, and he is coming from Kyushu, and he accumulated lots of experience doing ESD procedure at Kagoshima University, so feel free to ask him. And Dr. Motohiko Kato, yes, he is coming from Keio University, same university of mine, and he recently promoted as a director of endoscopy unit. So he, of course, is an expert endoscopist. Please ask anything about ESD. And Dr. Dobashi is coming from Jike University, and he is working together with Dr. Sumiyama, who is also our expert for therapeutic endoscopy, and he had a chance to stay at Mayo Clinic in Rochester, and he did lots of basic study working, Professor Gustaf, right? Yes, working together with Gustaf. So he knows a lot of secret devices and technical tips of doing a lot of advanced procedure And Dr. Sekiguchi is coming from Kobe University, and he is working together with Dr. Toyonaga, who is a master of ESD procedure. Okay, so we have lots of Japanese faculty here. It is a very unique opportunity that you can learn tiny technical tips or tricks directly from the Japanese master. I think a tiny technical tip makes a huge difference for the quality of the ESD procedure and the safety of the procedure. So I hope that all of you can bring back some new idea or technique from this course. Thank you very much. Thank you, Professor Yohagi. Now it's my pleasure to introduce U.S. faculties. I handpicked excellent faculties, as usual, and I brought back many of the people who have been teaching here at ASJJ's course. First, Hiroo Aihara from Brigham and Women's. Not much introduction needed. He is very famous. Amrita Sethi from Columbia. And Sergei Kansavoie, emergency medical at Baltimore. Makoto Nishimura from Memorial Sloan Kettering. And Juha Wong from Stanford University. Sawani, sorry, I couldn't pronounce your last name yet, from Johns Hopkins. And finally, last but not least, Andy Wong from Virginia, University of Virginia, West Virginia. No, University of Virginia, University of Virginia. Let me correct that. Let me go over the housekeeping items. ASJJ is committed to the higher education. We disclose all the conflict of interest. If you see any of the conflict of interest, please report and just let us know. We try to be as neutral as possible and fair and evidence-based. We cannot do this course without industry support. There's no question about it. And we're so happy to just work together with all the industries who produce many items for endoscopic treatment as well as the EMR ESDs. Boston Scientific, Irby USA, Fujifilm, Medtronix, Microtech, and Olympus Corporation America. Thank you very much for your kind support, and they will be here throughout the course. Additionally, there are many in-kind support provided. We have Apollo Endosurgery for sutures and X-TAC and other things. Boston Scientific, ComEd, Creo Medical, Irby USA, Fujifilm, Medtronix, Microtech, Neptune, a medical pathfinder, and Olympus all provided multiple devices. So this is a unique opportunity to compare products and see what's the features that are really useful for the specific indications. Almost all these stations are equipped with multiple devices. And if you have specific desire to use specific products, please let us know. We'll situate to the station for you. There are exhibitors outside. There's a table demonstrating products, and they're happy to field calls, Irby, Fujifilm, and Microtech. So please go visit them and discuss any items you want to discuss. We're also committed to the diversity, equity, and inclusion. So please spread your word. We are committed to these initiatives. We really need to incorporate all the people for this education. Now coming to the hands-on sessions. When you enter the bioscan, probably many of you have been here before. So if you're going to the animal lab, there's a bathroom and then the changing room. Then you change into the scrub and go into the animal lab. The scrubs will be available in the locker room, and there's a locker. So you can use the locker to store any items. Disposable gowns are available inside the animal lab. And lab courts are reserved for faculty only. So you can see who's going to be a faculty and who's a learner. Food and drinks are not allowed in the lab. So if you want to have a break, come out, go to the bathroom, take a break, and come back to the lab. That's okay, too. You can just talk to your teacher. And ideally, if you change into scrub in the morning, that would reduce the time to change and going to the lecture to the hands-on, that would be reduced. So that would be very beneficial. Now tomorrow, we're going to have a photo session. We want to include everyone for photo. If you want to be nice and stylish, you don't have to change tomorrow, but make sure you change early after the photo shoot. So the photo session is going to be at lunchtime tomorrow. When you're asking questions, please press the button on the microphone in front of you. And if there's a red light, then you're active. And when you're done, just push again, it's deactivate, so that everybody can hear. For virtual audience, please use a Q&A box, not the chat, so that we can see what kind of questions coming in, and we can sort things out. We would like to hear your online evaluation when you're done with the course. Please give us a feedback, what worked well, what didn't work well. And we want to improve every time we do this course. So far, we have seen a tremendous improvement over the years. By the way, this is the 10th year for this course. And we're really happy that this is helping United States and most likely Europe and South Americans EST capability. And thank you all the Japanese faculty and U.S. faculty for doing education over the years. CME credit is available as well. If you want a CME credit, please make sure that you check box all these items. Now, Terrence, are you ready? Dr. Tanaka, the current JGS president, couldn't come this time. So he recorded a video for us to greet from Japan. Go ahead. Welcome to the ASG JGS advanced ESD course. I am Shinji Tanaka, president of JGS. I believe you already have a lot of experience, but this is a precious and very practical training course to learn advanced ESD methods directly from world-renowned faculties from both U.S. and Japan. I heard the course has a history of about 10 years. Not only discovering latest ESD techniques, you may enjoy talking to the top-class experts and like-minded colleagues, or I wish I could have been there too. Please make the most of this opportunity and further polish your skills. And after this two-day course, I really hope you will be the next new ESD leaders and make the ESD even more popular in the States. Please enjoy and learn a lot. Thank you very much, Dr. Tanaka. You know, 10 years ago when Dr. Tajiri and Dr. Ken Wang met together, that was the beginning of this joint course. So I sincerely thank Dr. Tajiri and Dr. Wang as well. And former president of Dr. Inoue, I wish he's here as well. I mean, he's well and alive, but he couldn't travel. All right, any questions about the course so far? Okay, so we changed the format. We're going to do, everybody's going to be here doing lecture series and this case discussion. Then afternoon, after your break, we're going to go into animal lab. That's going to be all explained today. And we're going to have four hours. So each one would have four hours of ESD training, one-on-one. There are four stations, with a repeat of two. So two different kinds of stations available. One is a closure, suture closure, extract, clips, everybody, everything's there. So closure station. That closure station, you can do ESD as well. So if you want to experience a practice closure, that's the site you want to go. We're going to assign one hour for that. And then there's an additional station that's going to be more newer technologies, different overtube devices, traction devices are available. So we're going to be focusing on introducing new technologies in that station. That's going to be one hour as well. If you're not assigned today, you're going to be assigned tomorrow. So don't be nervous if you don't get to do the suture today. You're going to get to do it tomorrow. Okay? You're going to have two hours with Japanese faculty, solid two hours, no interruption. So use that hour to your best. And then you're going to move to the other stations. It's going to be more one-hour segments. So make sure that two hours is really solid. And when you paired with Japanese faculty, you're going to have two hours. So that's one thing you should remember. Tomorrow, we're going to have half of the group would have a live animal. And we're trying to assign as long as you can on the animal lab. I mean, live animal model. And that's a time you want to just practice what you learn and try to perfect your technique. Okay? Any questions? Okay. So majority of ESD stations, to your liking, what you need to know, what you need to practice, what you need to learn. That's the station you talk to the teachers. And senior faculty will be rotating, floating if you have any questions. But most of the time, you're on one-on-one. You probably don't have time to ask them questions. Maybe after hours. After everything is done, there's a little break for cocktail hours before you head back to the hotel. So that's the time we can wind down, just exchange contact information if you want, and ask questions.

Norio Fukami

Medical Clinic Arizona

personalized learning

ESD procedures

JGS