Innovations In Gastrointestinal Endoscopy

This book covers novel innovations in the field of gastrointestinal endoscopy. The procedures included in the book are related to procedures relating to Esophagus, Stomach, Duodenum, Biliary Tract, Pancreas and Colon. The chapters are based on novel techniques which are Gastric Peroral Endoscopic Myotomy, Endoscopic Gastrojejunostomy, Tunnel Endoscopic Submucosal Dissection, Endoscopic Ultrasound Guided Biliary and Gall Bladder Drainage, Endoscopic Esophageal Plication, Submucosal Tunneling Endoscopic Resection, Anti-reflux Mucosectomy, Radiofrequency Ablation of Biliary Tract, Esophagus. It also covers Endoscopic Gastric Sleeve, Full Thickness Resection, Endoscopic Mucosal Resection of Colon, Esophagus and Stomach, Duodenal Mucosal Resurfacing, Electronic Chromoendoscopy, Stenting for Pancreatic Walled Off Necrosis, Esophageal Cryotherapy and Gastric Balloons. All the procedures are explained by an expert in the field with succinct drawings and images. This collection is to enhance learning interface for newly trained gastroenterologists, experienced gastroenterologist and endoscopists in general who want to know about these procedures.

This book is the proceedings of Falk Symposium 166 entitled ‘GI Endoscopy – Standards and Innovations’, which was held in Mainz, Germany, on 18–19 September 2009. It highlights current knowledge and demonstrates standards of medical practice as well as shedding light on upcoming challenges and innovations in gastrointestinal endoscopy. Internationally renowned experts in this exciting field contribute chapters on oesophagus, stomach, small bowel, bile ducts, colon, pancreas, endoscopic ultrasound, and future perspectives.

Endoscopy is a fast moving field, and new techniques are continuously emerging. In recent decades, endoscopy has evolved and branched out from a diagnostic modality to enhanced video and computer assisting imaging with impressive interventional capabilities. The modern endoscopy has seen advances not only in types of endoscopes available, but also in types of interventions amenable to the endoscopic approach. To date, there are a lot more developments that are being trialed. Modern endoscopic equipment provides physicians with the benefit of many technical advances. Endoscopy is an effective and safe procedure even in special populations including pediatric patients and renal transplant patients. It serves as the tool for diagnosis and therapeutic interventions of many organs including gastrointestinal tract, head and neck, urinary tract and others.

This book is a comprehensive, state-of-the art update of the field of endoscopic imaging. The approaches to novel imaging and cutting edge techniques are demonstrated in the context of gastrointestinal endoscopic imaging, with discussions on both techniques in use and exploration of novel imaging platforms on the horizon in gastrointestinal endoscopy. Designed to convey practical information on these innovative approaches in a user-friendly manner, each chapter focuses on the principals of the technology under discussion, highlights key clinical indications, demonstrates the equipment and set up required, covers the basic technique, and reviews complication profiles, and comparison to standard or alternative approaches. Chapters also provides the expert’s tips and tricks for the reader to more practically and easily translate the information provided into safe and successful practice. The volume is also accompanied by videos demonstrating highlighting certain techniques. Written by experts in the field, Endoscopic Imaging Techniques and Tools is a valuable resource for clinicians, trainees, and researchers interested in the field of endoscopic imaging.

Evidence suggests that medical innovation is becoming increasingly dependent on interdisciplinary research and on the crossing of institutional boundaries. This volume focuses on the conditions governing the supply of new medical technologies and suggest that the boundaries between disciplines, institutions, and the private and public sectors have been redrawn and reshaped. Individual essays explore the nature, organization, and management of interdisciplinary R&D in medicine; the introduction into clinical practice of the laser, endoscopic innovations, cochlear implantation, cardiovascular imaging technologies, and synthetic insulin; the division of innovating labor in biotechnology; the government- industry-university interface; perspectives on industrial R&D management; and the growing intertwining of the public and proprietary in medical technology.

A critical appraisal of recent achievements What at the beginning of the last century started as a struggle to develop new devices for the endoluminal exploration of the digestive system has resulted in unexpected achievements in the field of advanced high-tech endoscopy such as interventional endoscopy and refinements in diagnostic resolution. This publication reviews some of the established major progress which has recently been made with regard to diagnostic and interventional endoscopy, including methods that are currently becoming part of today's clinical management. A critical evaluation of these methods is, however, mandatory as the enthusiasm for new technologies may result in their being introduced precipitately, without thorough prior evaluation in the form of adequate clinical trials: only with the help of such studies can individual applications be optimized. Last but not least, the importance of parallel instruments such as a self-administered symptom questionnaire to assess subjective manifestations and needs is stressed. This critical update on some of the latest issues in diagnostic and interventional endoscopy presents a valuable source of information for those working in clinical practice.

Each chapter of this new book on advanced lower GI endoscopy and endoluminal surgery focuses on the thought process and step-wise technical approach to the condition and procedure listed. By using this unique method, practitioners ranging from surgeons-in-training, gastroenterologists-in-training and those early in their career to senior colorectal specialists and gastroenterologist who want to incorporate or improve their advanced endoscopic skills will be able utilize techniques and learn from this gathering of experts. The guiding principle of this work is to create a resource for surgeons and gastroenterologists that extends beyond the currently available texts, and that surgeons and gastroenterologists can turn to when wanting to “brush up” on techniques, find a useful “tip or trick” for a complex patient, or simply learn a reproducible methods for advanced endoscopic procedures. This unique book highlights current knowledge, demonstrates standards of medical care, and provides clear step-by-step reproducible techniques even for the most advanced procedures. Beyond the simple application of technical knowledge the book addresses the deeper questions about the optimal “next step” in dealing with more complex patients (i.e., difficult polyps, gastrointestinal bleeding, IBD). International experts also address future challenges and innovations in lower gastrointestinal endoscopy. Finally, it focuses on specific “tips and tricks” that experts in the field have learned. The format follows that of both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. Throughout the text, each author provides an ongoing narrative of his/her individual techniques along with color illustrations and diagrams to “personally” take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic. Additionally, where appropriate, links to online videos will give the reader an up-front look into technical aspects of EMR, ESD, endoscopic stent placements, CELS, as well as NOTES. The editors and contributors to this book are those with nationally and internationally recognized expertise in lower gastrointestinal endoscopic and endoluminal interventions, have taught many international courses, and have numerous peer-reviewed publications. This book will be useful to colorectal surgeons, general surgeons, and gastroenterologists who want to learn or improve their skills in lower gastrointestinal endoscopy and advanced endoscopic interventions. Furthermore, this book will be of particular interest to the surgeons-in-training, and gastroenterologist-in-training that are often called upon to manage a variety of colorectal conditions through an endoscopic approach. This would ultimately serve as an invaluable reference for any physician or surgeon with a vested interest in caring for patients with simple or complex colorectal disease.

The field of interventional endoscopy has developed and expanded at an incredible pace over the last decades, and there appear to be few limits to its application in any part of the gastrointestinal tract. The topics presented in this publication highlight some of the most current aspects, controversies and recommendations in selected areas of interventional endoscopy. Besides careful clinical examination and individualization of the endoscopic intervention based on the patient's characteristics, it is imperative to understand the biology and behavior of gastrointestinal diseases such as early neoplasias of the esophagus, stomach and colon in order to identify the best possible endoscopic therapy. A key instrument among novel developments is the double balloon enteroscope, which has opened a new access to the small bowel. Last but not least, the therapy for most pancreatic fluid collections has evolved from a primary surgical approach to a primary endoscopic one, leading to a better understanding of the pathophysiology and anatomy of these collections. This collection of state-of-the-art reviews and original contributions will be a most helpful guide for those striving to keep abreast of current developments.