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Interventional GI Endoscopy
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Lectures

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Endoscopic surgery

Professor GB Cadière (Belgium)

June 2007
English - 22'23''

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Table of contents

1. Laparotomy
2. Laparoscopy
3. TransOral Foregut Surgery (TOFS)
4. TOFS limits
5. Limits of devices
6. TOFS techniques
7. TOFS indications
8. GERD
9. Nissen fundoplication principle
10. Post laparoscopic surgery aspect
11. Sphincter / length of high pressure
12. Manometry
13. New symptoms occurring after antireflux surgery
14. Esophyx - endoluminal fundoplication
15. Esophyx device
16. Esophyx handle end
17. History
18. Procedure description
19. Device introduction
20. Z-line identification and immobilization of device
21. Helix insertion
22. Tissue retraction
23. Deployment of stylet and fasteners
24. Creation of a 200° valve
25. Repeat each step
26. Postoperative endoscopy
27. Phase 1 follow-up and patient characteristics
28. Results
29. Post-procedure follow-up
30. Follow-up at 12 months
31. ELF-created valves
32. Valve length and circumference
33. Unsatisfied patients
34. Nissen fundoplication 6 months after Esophyx procedure
35. Esophyx procedure after 2 years of Nissen fundoplication
36. Conclusion
37. Phase 2: multicenter sites
38. Follow-up at 6 months
39. Satisfaction index
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Endoscopic surgery

Doctor P Meier (Germany)

June 2007
English - 13'38''

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Table of contents

1. Introduction
2. Therapeutic options
3. Radiologic imaging
4. Case study
5. Case results
6. Conclusions
7. Message
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Doctor B Schumacher (Germany)

June 2007
English - 20'48''

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Table of contents

1. Submucosal tumors (SMT)
2. EUS features / submucosal tumors
3. Gastrointestinal stromal tumors (GIST)
4. GIST diagnosis
5. EUS for diagnosis malignancy
6. EUS and FNA
7. Submucosal tumors and EUS
8. SMT: endoscopic techniques
9. Cap technique
10. SMT in the esophagus
11. Enucleation techniques
12. Submucosal tumors: en bloc resection
13. GIST tumors: endoscopic removal
14. Conclusion
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Doctor T Toyonaga (Japan)

June 2007
English - 31'31''

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Table of contents

1. Introduction
2. Limitations and problems of conventional EMR
3. Conventional EMR and ESD
4. Superficial expanded gastric cancer
5. Tubular adenocarcinoma
6. Strategy for early gastric cancer
7. Incidence of lymph node metastasis from early gastric cancers
8. Gastric cancer without metastasis?
9. Necessity of en bloc resection
10. ESD
11. Technical difficulty and tips
12. Manipulation of the IT knife
13. Technical tips of transverse incision using IT knife
14. Approach to the lower gastric body
15. Manipulation of the scope
16. Use of needle knife
17. Manipulation of needle knife
18. Intraoperative perforation
19. Invention of endo-knives
20. Short needle knives
21. Superficial esophageal cancer
22. Entire circumferential resection
23. Invention of water jet short needle knife (flush knife)
24. Usefulness of Flush knife
25. Esophageal ESD
26. Use of hook knife
27. Manipulation of Flush knife
28. Marking
29. Longitudinal incision
30. Trimming
31. Submucosal dissection
32. Hemostasis
33. Resected specimen
34. Prevention of bleeding
35. Prevention of stricture
36. Incidence of lymph node metastasis from superficial esophageal cancer
37. Gastric ESD
38. Advantage of Flush knife
39. Characteristics of submucosal layer
40. Mucosal incision
41. Precoagulation
42. Trimming
43. Colorectal ESD
44. Flex/Flush knife and sodium hyaluronate
45. Early rectal cancer
46. EST in caecum
47. Complicated situations
48. Approach to fibrous submucosal layer
49. Use of hook knife
50. Dissection of fibrosis using Flush knife
51. ESD
52. Complications of ESD using Flush knife
53. Summary
54. Conclusions
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Doctor N Yahagi (Japan)

June 2007
English - 31'42''

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Table of contents

1. Introduction
2. Purpose of endoscopic resection
3. Major endoscopic resection techniques
4. Issue of conventional EMR methods
5. Local recurrence rate after EMR
6. Endoscopic Submucosal Dissection (ESD)
7. Importance of en bloc resection
8. Endo-therapy accessories for ESD
9. Features of Flex knife
10. Chronological changes of mucosal elevation
11. Large superficial gastric tumor treated by ESD
12. Local recurrent tumor with scar
13. Tumor in difficult location
14. Current indications for ESD
15. Results of gastric ESD
16. Technical difficulties of ESD: esophagus
17. Treatment strategy for SCC
18. Procedure of esophageal ESD
19. Circumferential resection
20. Indication for esophageal ESD
21. Technical difficulties of ESD: colon
22. Problems of ESD in the colon
23. Indications for colorectal ESD
24. Requirements for curative resection
25. Large LST crossing a haustral fold
26. Colonic lesion
27. Case of mucosal cancer
28. Large LST granular type
29. Small rectal carcinoid tumor
30. Technical difficulties of ESD: duodenum
31. Large duodenal adenoma
32. Allocation of ESD
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Doctor H Yamamoto (Japan)

June 2006
English - 23''

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Table of contents

1. Background for use of EMR
2. Role of ESD & presentation of various ESD techniques
3. Examples of use of ESD: use in stomach
4. Use of ESD in the colon
5. Examples of GI cancers treated by ESD: esophageal cancer
6. Results of ESD in colon cancer
7. Tips for safe ESD
8. Conclusions

Hironori YAMAMOTO - IRCAD/EITS

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Doctor R Chuttani (United States)

June 2006
English - 19''

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Table of contents

1. Introduction: Full thickness plication concept
2. Description of current Plicator
3. Its use in full thickness resection & results
4. Other methods of endoscopic resection: cithara & strip mucosectomy
5. Transmural resection using a flexible stapler

Ram Chuttani - IRCAD/EITS

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Doctor R Chuttani (United States)

June 2006
English

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Table of contents

1. Suture treatments for GERD & current status of the Plicator technology
2. EndoCinch® vs. Plicator
3. Full-thickness plication technique & device presentation and use
4. Study results & potential improvements relating to the use of the Plicator
5. Complications
6. Other studies: Plicator vs. sham trial

Ram Chuttani - IRCAD/EITS

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Doctor R Chuttani (United States)

June 2006
English

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1. Endoscopic closure for fistula/perforation
2. Endoscopic restrictive gastroplasty for obesity: series of full-thickness plications

Ram Chuttani - IRCAD/EITS

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Professor H Inoue (Japan)

June 2006
English - 28''

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Table of contents

1. Treatment strategy for mucosal cancer
2. Basic principles of EMR & cases of EMR/ESD
3. Circumferential EMR
4. Other techniques of ESD: Triangle Tip Knife
5. Applications of ESD in upper GI tract & clinical results
6. Laparoscopic + thorascopic surgery for esophageal lesions
7. A few other cases of tumor lesions
8. Conclusion

Haruhiro Inoue - IRCAD/EITS

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Doctor J Arts (Belgium)

June 2006
English

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Table of contents

1. Reflux disease: semiology & various endoscopic treatment modalities
2. Focus on Stretta Procedure: principles
3. Indications for Stretta procedure
4. Treatment results: overview of clinical studies
5. Side effects of Stretta procedure
6. Underlying mechanical effects
7. Future for Stretta procedure
8. Conclusions

Joris Arts - IRCAD/EITS

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Professor GB Cadière (Belgium)

June 2006
English

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Table of contents

1. GERD mechanisms & laparoscopic Nissen fundoplication
2. Nissen fundoplication: results & quality of life
3. Endoluminal surgery to improve GERD
4. Esophyx™, a new technique of endoluminal surgery: clinical studies
5. Stepwise description of the procedure using the Esophyx™ device
6. Patient follow-up & results of the procedure
7. Conclusion

Guy-Bernard Cadière - IRCAD/EITS

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Doctor H Yamamoto (Japan)

June 2006
English

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Table of contents

1. Double-balloon endoscopy (DBE): background & system description
2. Rationale of DBE technique: anterograde + retrograde DBE
3. Double Balloon Endoscope: retrograde insertion
4. Clinical indications of DBE: survey of experiences
5. Results and advantages of DBE: a few pathological examples
6. Cases of therapeutic DBE: endoscopic hemostasis
7. Balloon dilation therapy for stricture
8. Other applications of DBE: retrieval of foreign bodies
9. Future of DBE & additional applications (eg. for adhesions, for Roux-en-Y)
10. One-man method of DBE
11. Conclusions

Hironori YAMAMOTO - IRCAD/EITS






ISSN: 1778-3852

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