Okay, we come over to this station over here. He's injecting a solution to try to lift the lesion. He's able to advance that device down working China, using a little competition goes a long way. It's a perfect obviously a perfectly safe environment working on this. But when we're working on patients were always very focused on what's going on. So here you can see Tony is getting ready to advance the instrument out the scope. Looking at the monitor camera. Once it comes out of the endoscope I see that. Thank you for that. He's controlling the opening and closing. He's advancing it. Now she's giving us an instruction on how to actually deploy far away. Now we're going to pull that device out of the endoscope and if they wanted to place more clips, which is typically the case, a lot of interventions that we employ requires a couple of clips if we're treating an African blood vessel. We're trying to close a polypectomy site. So, this is Dr. Arnie Markowitz who's demonstrating. We're doing some clipping here. Oh, we're doing some electrocautery. So we saw earlier, Dr. Opstein demonstrate the electrocautery probe, and that's what you're about to see here. One of our in-person attendees is handling the scope and getting ready to advance the catheter out of the working channel. Once you see it, you'll see that striped metal. See the striped metal? That's the bicap probe. So the electrical current is flowing from one piece of metal to the other, as long as the tissue is in contact. The tissue is the contact. So now she's going to step on the pedal once she's ready to actually actuate and deliver the cauter. So we always want to make sure we're precise with our areas that we're treating, and so that's what they're doing is they're taking their time to do that. Now they're very happy, and so she's going to step on the pedal, and it'll take some time, but you'll start to see the electrical current start to show up. We just have to get our connection. We're going to go over to the next station, we're just having a little bit of a break. Here we have Dr. Blessing and they're working with the same, they're working with the same device it looks like, using bipolar. And then we've got our technical. I see the nice thing is that all of our attendees get to handle the scope and see how things are handled. It's quite disorienting at first but they pick it up really remarkably quickly. So this is actually not a, we often have technical issues that we have to stop and reset and that's what's happening right now. There you go, okay, so they think they have this salt, you'll see here in a second. Okay. Thank you. So the second important point is really frustrating because imagine that you have an ulcer with a visible vessel or it's bleeding or you're working heavily and you're sitting there so comfortably or cooking food, which is so important that we have convoy in-person in that way, especially if you have co-hired rotating staff and a lot of people will assume that the doctor knows everything and the doctor should know everything. you Okay. Excellent. Now we're doing some basic stroke handling, driving into the big stomach of Dr. Abugande's patient. Good. And you can see the up, down, and formation of the upper and lower limbs of the patient. Up, down, and coordination of the insertion is really what takes some practice. Here you can see the scope as it's coming into the pig's stomach. That's called a retroflexion, where the scope is looking all the way back around. Let's see. Okay, so we finally got the BICAP probe operational here at Dr. Glessing's station, and she's explaining to them how it works, what we use it for, how we control bleeding. You can see there's a little bit of bubbling going on at the tissue. It's starting to bubble a little bit more now. Oh my God. You can see, after she's delivered the energy, she picks up and there's a little divot there from where the cautery was applied. That would be typically used to try to compress an abnormal, a bleeding blood vessel and to coagulate it to sort of seal the blood vessel, so to speak. Yeah. Okay, so we're going to go over to the other station now. We're going to see argon plasma coagulation. So here, Dr. Markowitz is explaining, you can see the APC probe is out of the scope and you can see that energy being delivered without contact to the tissue, and it's creating a coagulation effect, which can be used to either destroy tissue or stop any superficial bleeding. We really wouldn't use this to try to control bleeding from a large artery, but you can use it to treat very superficial bleeding from vascular malformations, which are tiny little abnormal blood vessels. And you can also use it, as we talked about during that polypectomy video, to destroy tissue or coagulate and ablate tissue that you were concerned might be present at the edge of a polypectomy. You can see they're depressing the pedal, and as they're depressing the pedal, the gas is being delivered out the tip and creating that spark and throwing the energy, if you will, at the tissue of the ventricles. Okay, so there you have a brief overview of how our Bioskills Lab works. There's a lot of exciting participants here that are getting their hands on the scope. We certainly hope you guys have a chance at some point to come in person to a course here and get a chance to interact with these models and get your hands on the instruments. So we're gonna take a break here and we'll reconvene for the closing sessions over at the conference center. Thank you.

Dr. Arnie Markowitz

Dr. Glessing

procedures

devices

controlled environment