Advanced Endoscopy Fellows Program | September 2024-Third Space Trouble Shooting

Video Transcription

Video Summary

The video lecture focuses on troubleshooting adverse events in advanced endoscopy, particularly in third-space endoscopy cases like endoscopic submucosal dissection (ESD). Dr. Neil Sharma, Director of Interventional Endoscopy and Surgery, discusses the importance of patient selection and managing complications such as bleeding and perforation. He highlights a significant series that shows a 7% intraoperative bleeding rate for experienced practitioners. Sharma emphasizes knowing locational anatomy (e.g., above or below the diaphragm) to manage perforations effectively. The talk also covers strategies for maintaining intraoperative stability, the use of traction devices, and electrosurgical settings for bleeding control. Additionally, Dr. Sharma stresses postoperative care, proper instrument selection, and ensuring that lesions can be resected en bloc. Complications such as leaks, ischemia, and reflux are discussed, and the importance of mastering hemostasis in third-space procedures is reiterated. Patient outcomes in gastroesophageal and gastric peroral endoscopic myotomy are briefly explored, highlighting the role of patient selection and expectational management.

Asset Subtitle

Dr. Neil Sharma

Keywords

advanced endoscopy

endoscopic submucosal dissection

complication management

intraoperative bleeding

third-space procedures

patient outcomes