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Endoscopic aspects in diagnosis of gastroesophageal reflux disease and motility disorders: Bravo, capsule, and functional lumen imaging probe
Catheter-based testing remains the current standard of practice for the diagnosis of gastroesophageal reflux disease and esophageal motility abnormalities. Ambulatory pH testing and esophageal manometry have been in use for the past 40 years, but with the development of high-resolution manometry and multichannel intraluminal impedance testing, catheter-based testing has undergone significant recent technological improvement. Nonetheless, these tests continue to have limitations. In the case of ambulatory reflux testing, patient discomfort and limited activity remain significant problems. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - November 20, 2013 Category: Gastroenterology Authors: Richard K. Wood Source Type: research

Endoscopic Aspects in Diagnosis of GERD and Motility Disorders: Bravo, Capsule, and EndoFLIP
(Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - November 20, 2013 Category: Gastroenterology Authors: Richard K. Wood Source Type: research

Endoscopic aspects in diagnosis of gastroesophageal reflux disease and motility disorders: Bravo, capsule, and functional lumen imaging probe
Abstract: Catheter-based testing remains the current standard of practice for the diagnosis of gastroesophageal reflux disease and esophageal motility abnormalities. Ambulatory pH testing and esophageal manometry have been in use for the past 40 years, but with the development of high-resolution manometry and multichannel intraluminal impedance testing, catheter-based testing has undergone significant recent technological improvement. Nonetheless, these tests continue to have limitations. In the case of ambulatory reflux testing, patient discomfort and limited activity remain significant problems. For esophageal manometry,...
Source: Techniques in Gastrointestinal Endoscopy - November 20, 2013 Category: Gastroenterology Authors: Richard K. Wood Source Type: research

Table of Contents
(Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Tags: Frontmatter Source Type: research

Editorial Board
(Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Tags: Frontmatter Source Type: research

Training surgeons to perform flexible gastrointestinal endoscopy
Abstract: The extent and type of training involved in producing a competent flexible endoscopist has recently been debated. Traditionally, the number of procedures performed has been used as a surrogate for competency; however, the number of procedures required to achieve competence has varied, has not been validated, and does not take into account the cognitive portion of the procedure. In response, the American Board of Surgery has evaluated the entire Fundamentals of Endoscopic Surgery Program, as well as the Flexible Endoscopy Curriculum, to provide a consistent, scientifically accepted method of teaching and training ...
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Yuhsin V. Wu, Jeffrey M. Marks Source Type: research

Novel methods of enteral access
Abstract: A review of benefits, indications, techniques, and special populations when considering enteral access. The purpose of this article is not to provide an exhaustive in-depth review but to highlight major considerations when deciding which patient would benefit and what tools should be considered before procedure. The focus is limited to endoscopic enteral access and does not cover additional methods (radiologic or surgical). (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Pornthep Prathanvanich, Bipan Chand Source Type: research

Therapeutic flexible endoscopy replacing surgery: Part 3—Peroral esophageal myotomy
This article reviews the key steps of the procedure, and outlines the necessary skills, equipment, and instrumentation that are required to perform it. The existing literature regarding procedural and postoperative outcomes is reviewed, and recommendations are given regarding the symptomatic and physiological assessment of POEM patients going forward, so that the procedure can be objectively compared with the current standard of care, laparoscopic Heller myotomy. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Ezra N. Teitelbaum, Eric S. Hungness Source Type: research

Therapeutic flexible endoscopy replacing surgery: Part 2—Gastroesophageal reflux disease and its complications
Abstract: Gastroesophageal reflux disease (GERD) is a complex entity whereby gastric contents reflux into the esophagus owing to either a lack of a natural barrier between the stomach and esophagus or a dysfunction of foregut motility. In many cases, elements of both are present. GERD presents with either typical or atypical symptoms and can lead to metaplasia of the esophageal epithelium, a precancerous condition called Barrett's esophagus (BE). GERD is a chronic disease, and like other chronic diseases, it requires a thorough evaluation to deduce the exact etiology and also necessitates a dynamic and evolving spectrum of...
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Todd A. Worley, Rohan Joseph Source Type: research

Therapeutic flexible endoscopy replacing surgery: Part 1—Leaks and fistulas
Abstract: Flexible endoscopy has become an integral part of managing many surgical problems that in the past required open or laparoscopic surgical interventions. Stents, clips, suturing devices, glues, and vacuum systems can be used to control perforations, leaks, and fistulas in properly selected patients. Stents have gained place in the treatment algorithm for patients with esophageal perforation from various causes. Endoscopic clips are being used to close perforations in the gastrointestinal tract in addition to their use for bleeding. The technology is slowly evolving and larger clips are available for over-the-scope...
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Moaz Abulfaraj, Viney Mathavan, Maurice Arregui Source Type: research

Intraoperative endoscopy: An important adjunct to gastrointestinal surgery
Abstract: Flexible endoscopy has become an increasingly important skill for gastrointestinal (GI) surgeons, and there is no setting more important than the intraoperative setting for surgeons to employ endoscopic techniques during the course of surgical procedures performed on the GI tract. Endoscopic confirmation of pathology before initiating surgery, intraoperative anastomotic evaluation and margin assessment, and combined laparoscopic-endoscopic approaches to patient care are just a few examples emphasizing the need for surgeons to perform GI endoscopy as a routine adjunct to foregut, bariatric, and colorectal procedur...
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Robert D. Fanelli Source Type: research

Intraoperative endoscopy to identify lesions
Abstract: Intraoperative endoscopy is an important adjunct to surgical therapeutics. Endoscopy can improve the efficiency of operative interventions by localizing lesions and defining the extent of pathology. Different techniques can be employed to facilitate intraoperative endoscopy including sterile scope and nonsterile scope methods. Lesion marking can be accomplished using endoscopic or endoscopically guided surgical means. Air insufflation can often be utilized for easily accessible regions of the gastrointestinal tract (esophagus, stomach, rectum, and distal sigmoid colon). Carbon dioxide insufflation is most useful ...
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Benjamin K. Poulose Source Type: research

Use of endoscopy to prepare patients for surgery
Abstract: Gastrointestinal (GI) endoscopy is a useful tool for GI disorders; it is also important to collect information at the preoperative stage for patients who are going to have GI surgery. Endoscopy can offer therapeutic, curative, or palliative management of certain pathologies that can alter the need for the patient to undergo surgery. Endoscopic interpretation can contain a certain amount of individually variable observer subjectivity. Accordingly an appropriate standardized grading and staging terminology needs to be developed to obtain optimal results in the management of GI disorders. This section summarizes the...
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Jose Martinez, Edip Akpinar, J. Andres Astudillo Source Type: research

A modern history of the surgeon-endoscopist
Abstract: For millennia, physicians have endeavored to view the interior of the gastrointestinal tract to diagnose and treat diseases. It was not until the mid-20th century, with the development of flexible fiberoptic technology that the revolution of gastrointestinal endoscopy began. Throughout this process, surgeons have played a central role in the development of diagnostic and therapeutic modalities to manage the diseases they encountered on a daily basis. Here, we provide an overview of the modern history of flexible gastrointestinal endoscopy emphasizing the role of the surgeon-endoscopist (frequently in multidiscipl...
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Eric M. Pauli, Jeffrey L. Ponsky Source Type: research

Preface
Should surgeons perform flexible gastrointestinal (GI) endoscopy? This is a poignant question that both surgeons and gastroenterologists ask, especially when confronted with implementing endoscopy training requirements for general surgery residents or credentialing a surgeon to work in the GI laboratory. Some gastroenterologists might argue that surgeons do not have the training to perform high-quality endoscopy. Their busy practices are best focused on surgical interventions. GI surgeons counter with the argument that the natural evolution of surgery is to perform procedures with greater precision and less invasion and th...
Source: Techniques in Gastrointestinal Endoscopy - October 1, 2013 Category: Gastroenterology Authors: Brian J. Dunkin, Steven D. Schwaitzberg Source Type: research