This CME activity consists of the ASGE video, Diagnostic and Therapeutic Endoscopy in Patients after Ileal Pouch Surgery, followed by a post-assessment and evaluation.

Despite advances in medical therapy for ulcerative colitis (UC) over the past decade, approximately 20%-25% of the patients will eventually require surgical therapy. Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the surgical treatment of choice in patients with medically refractory UC or UC-associated colon neoplasia as well as in patients with familial adenomatous polyposis. Commonly fashioned pouch configurations include J pouch, S pouch, and K pouch (or Kock pouch), with the J pouch being most often constructed. The pouch surgery is a technically demanding procedure. The surgery significantly changes the bowel anatomy. While the surgery improves patient’s health-related quality of life and reduce the risk for colitis-associated neoplasia, mechanical, inflammatory, and functional complications are common. For gastroenterologists, colorectal surgeons, general surgeons, nurse practitioners and physician assistants, the recognition of the normal anatomy of various forms of the ileal pouch can be challenging, not mentioning the diseased states. In this video, we will provide stepwise teaching materials to help the viewer understand the anatomy of the ileal pouches, various forms of mechanical and inflammatory diseases. In the second half of the video, we will describe endoscopic treatment modalities in various pouch disorders, ranging from balloon dilation of stricture to needle knife treatment of anastomotic sinus.

See a preview of this video content here.

Practicing gastroenterologists, gastroenterology fellows and trainees, medical residents, physician assistants, and nurses.

Upon completion of this educational activity, participants will be able to:

• Be familiar with normal anatomy of J, S, and K and Barnett pouches
• Understand the disease classifications of ileal pouch disorders and their characteristic endoscopic features
• Learn principles and preparation of diagnostic and therapeutic endoscopy in pouch disorders
• Learn basic techniques of endoscopic therapy for pouch disorders

Video Release Date:    May 1, 2015
Online CME Release Date:      September 1, 2015
CME Expiration Date:  May 1, 2018

Expected Time of Activity Completion:  65 Minutes (1.00 CME Credit)

Windows Requirements: Operating system: Windows 7+
Browser: Internet Explorer 8+, Firefox 10+, Google Chrome 10+
Internet connection: DSL, cable modem, or other high-speed connection
Flash: Adobe® Flash® Player 12+

Macintosh Requirements:
Operating system: Mac OS X 10.6.8+
Browser: Mozilla Firefox 10+, Safari 5+, Google Chrome 10+
Internet connection: DSL, cable modem, or other high-speed connection
Flash: Adobe® Flash® Player 12+

To complete this activity, 
1. View the video.
2. Complete the Post –assessment by selecting the single best answer for each multiple choice question. You will be able to change your answer at any time until you click on the finish button. Multiple attempts are given and each question must be answered correctly before proceeding to the next question. Persons scoring 100% pass the test and can print a CME certificate. Exams can be saved to access at a later date. 
3. Complete the Evaluation.

You may complete the activity in one sitting, or you may save your work in progress and complete it at a later date. However, to earn CME credits, you must complete the activity prior to the CME expiration date. 

In order to claim credit, you must complete the Post-assessment and Evaluation. Completed CME will be tracked in your account and you can print a record of this CME activity at any time. 

For technical difficulties, please contact ASGE between the hours of 8:30am and 5pm Central Time at 1-866-353-ASGE (2743). For questions related to content or CME credits, please email education@asge.org.