GASTRO 2009, London, November 21-25, 2009

Recent endoscopic diagnostic and therapeutic innovations have enormously increased the range of services gastroenterologists provide their patients with, but they also imply a responsibility to ensure proper training and safe practice. GASTRO 2009 provides the opportunity for OMED, in cooperation with ESGE (European Society for Gastrointestinal Endoscopy) to present endoscopic research, live demonstrations of new procedures and hands-on teaching. At the ESGE/OMED Learning Area various activities will be offered from Sunday through Wednesday. Whether it be training sessions on biologic models, small interactive lectures from world experts or simply resting your legs and viewing of the 18 DVDs at the stations provided, the ESGE / OMED Learning Area is a must for all those interested in Endoscopy. Visit the OMED website for details and the download of the preliminary program of Endoscopy related offers at GASTRO 2009.

» Download the preliminary programe here

 MST: a universal endoscopic language through OMED, under the direction of
   Lars Aabakken

Common language is a prerequisite for communication everywhere, not least in medicine. This has been extensively developed in e.g. radiology and pathology. Similarly, in a visual discipline like gastrointestinal endoscopy, the language needs to be developed along common terms, making sure concepts and terminology are being used in a similar fashion among endoscopists.

The Minimal Standard Terminology (MST) for GI endoscopy is a standardization tool for endoscopy reporting. It offers selections of core terms to be included in reporting software for endoscopy. Behind them, a definitions catalogue is available, and an image atlas is being developed to further support standardization.

» Read more

 DDW Report: 2009 OMED Update on Endoscopic Research

As in previous years, OMED has asked a group of experts under the guidance of Dr Jonathan Cohen to give an overview of the endoscopic research presented at Digestive Disease Week. GI fellows from the New York City area training programs summarized scientific lectures and presented a report. This year, the abstracts selected for oral presentation at 22 ASGE topic fora as well as the scientific papers presented at the ASGE Plenary session are included in this review. Readers will note that this is just a sample of the breadth of innovative scientific work in the area of endoscopic research presented at DDW. However, the abstracts covered in this review should provide a good snapshot of the current areas of investigation—from initial reports of new techniques, to carefully controlled trials subjecting new methods to rigorous validation, to presentations of data addressing many of the key clinical practice issues we face today.

» Click here to view the report

 OMED Showcase: Centers of Excellence

This month OMED highlights the Therapeutic Endoscopy Group of St. Michael's Hospital in Toronto, Canada

The TWENTY-SECOND INTERNATIONAL COURSE ON THERAPEUTIC ENDOSCOPY, organized by the Therapeutic Endoscopy Group of St. Michael's Hospital, will be held at The Four Seasons Hotel, Toronto, Canada, on September 30 to October 3, 2009. The first course was held at the Wellesley Hospital in October of 1983. In 2001, the Wellesley Group moved to the new endoscopy unit at St. Michael's Hospital and continues as the Therapeutic Endoscopy Group.

“Our goal is to demonstrate and teach endoscopic techniques to practicing physicians and to build on the success of the preceding twenty-one courses. Live video transmission from the Endoscopy Unit at St. Michael's Hospital to the Conference Center at the Four Seasons Hotel will allow two-way communication between the registrants and the faculty. These transmissions will demonstrate a wide range of the latest therapeutic endoscopy techniques, treatments and assessments by international experts.” says Dr Norman E. Marcon from St Michael´s Hospital in Toronto, Canada.

Piecemeal endoscopic mucosal resection of a large hepatic flexure polyp

Dr. Michael Bourke from Westmead Hospital in Australia performs an endoscopic mucosal resection of a large sessile polyp at the hepatic flexure in a patient who is referred for this procedure since the previous doctor could not access the polyp.  Dr. Bourke injected saline with epinephrine and methylene blue into the submucosa proximal to the polyp.  An attempt was made at retroflexion, but the polyp could not be well seen.  Eventually, the patient was turned onto the back and the polyp changed position to a much more favorable location for polypectomy, with the polyp lying on the wall at the 5-6 o'clock position.  The snare was placed over a large portion of the polyp which was resected.  The remainder of the polyp was then removed with another application of the wire snare.  An excellent result was achieved.  The polyp turned out to be a tubulovillous adenoma.  The patient had previously been scheduled for surgery, but this colonoscopic procedure safely removed the polyp and surgical treatment was not necessary.

This procedure was performed at the therapeutic endoscopy course held annually in Toronto by Dr. Norman Marcon and associates.

» View live demonstration video

 NYSGE: New Developments in Capsule Endoscopy

By David Cave MD PhD and Manuel Martinez MD

The New York Society for Gastrointestinal Endoscopy is the largest regional GI endoscopy society in the United States. The Society is dedicated to the teaching and advancement of gastrointestinal endoscopy. The society runs numerous programs throughout the year, including an annual fellow’s endoscopy course each summer, and a major postgraduate endoscopy conference each fall. The next course will be held in New York from December 16-19, 2009.

Each month a syllabus entry from the 32nd Annual New York Society for Gastrointestinal Endoscopy Course can be accessed here. This month the entry is entitled New Developments in Capsule Endoscopy by David Cave MD PhD and Manuel Martinez MD.

Introduction to Hardware and Software
There are two capsule endoscopes that are currently available, the Endocapsule and the Pillcam SB. Both of these capsules are very similar in size, they are 26 x 11 mm. They image at two frames per second and have a battery life of about eight hours. Both devices transmit at radiofrequency and have an 8 lead sensor, which in turn is connected to a small hard drive that is worn on the belt allowing complete patient mobility during the study. The differences are that the Endocapsule has a CCD chip and the PillcamSB has a CMOS chip. Once a recording is completed, the hard drives are connected to a workstation, the data is downloaded and a video is created. These videos can be viewed at varying speeds; a report can be created, printed and distributed.  Each workstation is also capable of creating CDs for storage of the videos and transferring images to other media. At the present time, reading a capsule study takes between 30 minutes and one hour.

» Read more

 Brainteaser/image of the month

by Bjorn Rembacken

This was found in a 38 year old female undergoing gastroscopy for abdominal discomfort.

What is the likely diagnosis?

a) gastric adenoma

b) early gastric carcinoma

c) submucosal mass or tumour

d) H.P associated gastritis

e) gastric lymphoma

» Click Here for the Answer and Explanation

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