GASTRO 2009, Live Demonstrations

With only two weeks to go, OMED is preparing for this landmark meeting in London. The events include highest class endoscopy innovations and offer a vast variety of training opportunities. From Monday, November 23 to Wednesday, November 25, 2009, live demonstrations will be broadcast from three official OMED Centers of Excellence in Hyderabad, London and Rome. Every day, honorary lectures will be held towards the end of the live demo, to commemorate Francois Moutier, Sadataka Tasaka and Rudolf Schindler.

» View the Endoscopy program offered at GASTRO

Dr Nageshwar D. Reddy, Chairman and Chief of Gastroenterology at the Asian Institute of Gastroenterology in Hyderabad, India, will direct the Live Demo on Monday, November 23, 2009, beginning at 2.00 pm in Hall S 1/2/3.

Experts at the hospital will include J. Lau (Hong Kong), M. Bourke (Australia), T. Gotoda (Japan), G. Rao (India). Chairs at the ExCel Centre: H. Neuhaus (Germany), N. Marcon (Canada), I. Mostafa (Egypt).

Chairs at the ExCel Centre: H. Neuhaus (Germany), N. Marcon (Canada), I. Mostafa (Egypt).
Francois Moutier Lecture: Therapeutic Endoscopy: From evidence-based medicine to craftsmanship (G. Costamagna, Italy).

Dr Brian P. Saunders, Director of the Wolfson Unit for Endoscopy, will direct the Live Demo on Tuesday, November 24, 2009, beginning at 8.30 am in Hall S 1/2/3. Experts at the hospital: T. Ponchon (France), Dr. Toyonaga (Japan), Dr. Yamamoto (Japan), C. Fraser (UK), N. Suzuki (UK) Chairs at the ExCel Centre: J. Waye (USA), C. Williams (UK), E. Swarbrick (UK).
Sadataka Tasaka Lecture: Recent advances of electronic endoscope: Image-enhanced Endoscopy (H. Tajiri, Japan)

Professor Guido Costamagna, Head of the Division of Digestive Endoscopy at Policlinico A. Gemelli will direct the Live Demo on Wednesday, November 25, 2009, beginning at 8.30 am in Hall S 1/2/3. Experts at the hospital: J. Deviere (Belgium), R. Hawes (USA), H. Neuhaus (Germany) Chairs at the ExCel Centre: G. Haber (USA), C. Navarrete (Chile), B. Rembacken (UK).
Rudolf Schindler Lecture: Endoscopy and the ugly duckling (J. Waye).

 GASTRO 2009 – Visit OMED at the booth next to the registration area:

Don´t miss the OMED raffle of Colonoscopy: Principles and Practice by Jerome D. Waye, Douglas K. Rex & Christopher B. Williams. This state-of-the-art reference guide covers all aspects of the performance, technical and clinical background to colonoscopy.

The second edition of this prize winning book focuses on patient care, and provides explanations on how to perform the procedure effectively and make the best outcome for your patients. It serves as a detailed manual of procedures, extensively illustrated with diagrams and photographs, and there is an accompanying DVD with multiple demonstrations of technique.

OMED will raffle one issue of this invaluable compendium on all aspects of colonoscopy. Submit your name at the OMED booth any time and don´t miss the drawing at the booth on Wednesday, November 25, 2009, 10.00 am. You will find the announcement in your congressbag.

 GASTRO 2009

GASTRO 2009 promises to be a highlight of 2009 for GI professionals around the world as it offers the perfect balance of basic science and clinical practice, and covers all GI disciplines gastroenterology, endoscopy, digestive oncology, nutrition, digestive surgery, and hepatology.

For those who missed the First International Symposium on Sedation in Digestive Endoscopy in Athens, September 2009, GASTRO 2009 will give opportunity to learn more about the achievements of this successful meeting. Sponsoring societies were the World Organization of Gastrointestinal Endoscopy (OMED), European Society of GI Endoscopy (ESGE) and the Hellenic Society of Gastroenterology (HSG). World expert endoscopists and anesthesiologists, following discussion and voting, formulated thirty evidence-based statements, which will be published soon. The topics covered were:

• Rate of using sedation worldwide
• Basic principles
• endoscopic sedation
• Assessment and monitoring of the patient
• Avoiding and managing complications of sedation
• The use of propofol by gastroenterologists
• Training for sedation in gastrointestinal endoscopy

A Common Interest Group Meeting will take place on Monday, November 23, 2009 5:15 pm in room SG24, and an outstanding faculty will lecture on the outcome of this exciting meeting. You are invited to attend.

» Click here to view the OMED activities offered at GASTRO

Tight schedules and long days take their toll, so if you feel like having a break, watch out for one of the more than 30 cafés, bars and restaurants at ExCel, London. If you’re out and about on campus, you’ll discover a mouth watering array of dining experiences, while the venue itself offers a host of equally enticing options. From a quick bite on the move to a relaxing three course meal, there’s something to suit all tastes and budgets. The only limit is your appetite and imagination.

Additionally, coffee breaks and lunches are offered through the organizers.
Coffee, tea and biscuits will be served during the morning and the afternoon coffee breaks from Monday, November 23 until Wednesday, November 25, 2009 free of charge to all registered GASTRO 2009 UEGW/WCOG, London participants. Lunches will be served to registered GASTRO 2009 UEGW/WCOG, London delegates from Monday, November 23, until Wednesday, November 25, 2009, from 12:30 until 14:00. The catering areas are located next to the technical exhibition in Hall N1/2 and next to the poster exhibition in Hall S10/11/12. On Saturday, November 21, and Sunday, November 22, 2009, coffee breaks and lunches for the Postgraduate Teaching Programme and the ESGENA/GI Nurses 2009 Conference are embedded in the programme.

 OMED Showcase: Centers of Excellence

This month OMED highlights the Egypt Training Centre (ETC),Cairo, Egypt.

The Egypt Training Centre offers services in six endocopy rooms, three of which are additionally equipped with X-Ray facilities. Staff includes 27 endoscopists and 10 specialized nurses, performing 150 diagnostic and therapeutic procedures per week. The ETC will host the 2nd Hepatology and Gastroenterology Post graduate course and 11th International Workshop on Therapeutic Endoscopy, December 11-14, 2009.

The Centre has hosted several training courses in the last 5 years with 72 trainees from 25 countries.

Video on treatment of gastric varices: Professor Mostafa, Center of Excellence in Cairo, Egypt, demonstrates the technique of injection of histoacryl for treatment of gastric varices. Dr. Richard Kozarek discusses the various options for therapy of this type of varices. In the video, a large gastric varix is shown, and histoacryl is injected directly into the varix. Lipiodol is injected immediately after histoacryl in order to prevent the glue from obliterating the channel in the catheter. Following this, water is flushed through the system. Soon after injection, the varix is pierced with the injector needle to see whether bleeding occurs. If there is no bleeding, it is assumed that the varix is obliterated.

» View live demonstration video

 Centers of Excellence 2

A second video highlights the Wolfson Unit for Endoscopy, one of the three host centers of the live transmission at GASTRO 2009, focusing on colonoscopy, enteroscopy and advanced luminal therapies.

St. Mark’s Hospital, Harrow, London, UK, has a long tradition of caring for patients with complex gastrointestinal problems, and the Wolfson Unit for Endoscopy plays a central role in the hospital providing advanced diagnosis and minimally-invasive therapy.

Led by Dr. Brian Saunders the unit takes referrals from throughout the UK for complex endo-luminal endoscopies, particularly therapeutic colonoscopy and small bowel enteroscopy and has the UK’s largest single centre colon cancer prevention programmes for high risk groups. There are 6 state of-the-art endoscopy suites and an academic centre co-ordinating teaching and research, allied to Imperial College of Science and Technology, London. Five specialists endoscopists are supported by more than 20 surgeon, physician and nurse endoscopists in performing >11,000 procedures per year including >6,000 colonoscopies. Each year the unit provides educational opportunities as a National Training Centre to junior and senior clinicians with courses and workshops in colonoscopy technique, advanced and basic therapeutic endoscopy, double balloon enteroscopy, bowel cancer screening, training the trainers and nurse Endoscopy.

Video Colonoscopy: Dr. Brian Saunders, OMED Center of Excellence, London, demonstrates the technique of colonoscopy. This is an excellent tutorial on intubation, scope handling, and a demonstration of the “scope-guide”, a magnetic imager that creates a computerized view of the colonoscope continuously during the procedure. The imager is external to the patient and information is sent through miniature electromagnets embedded within the instrument. The processor actually portrays the actual twists, bends and loops of the instrument without the need for fluoroscopic control. Dr. Saunders is a world expert in colonoscopy and provides his patient with a minute-by-minute explanation of the entire procedure, fully explaining the intricacies of colonoscopy. This video will provide considerable information for the beginner and includes several points of interest even for the most experienced colonoscopist.

» View live demonstration video

» Click here to view the OMED Video library

 NYSGE: Advanced Imaging in Barrett’s Esophagus

By Prateek Sharma, M.D. VA Medical Center, Kansas City, USA

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 ‘Advanced Imaging in Barrett’s Esophagus’ by Prateek Sharma, M.D., VA Medical Center, Kansas City, USA.

Barrett’s Esophagus (BE) is a metaplastic change in the esophagus that results in replacement of the normal squamous lined epithelium with intestinal metaplasia. The incidence of esophageal adenocarcinoma has rapidly increased in recent years and BE has been found to be present as a precursor lesion in many of these cases. Patient’s with BE are thought to have an annual risk of developing esophageal cancer of 0.5% per year, substantially higher than the general population, but the absolute risk of developing cancer in BE patients is low. Endoscopic screening of subjects with chronic reflux symptoms has been recommended as a method of detecting BE and early cancer and despite the lack of clinical evidence, BE patients are then routinely enrolled in surveillance programs.

Diagnosis of BE
Endoscopic assessment of the extent of Barrett’s esophagus (endoscopically visible esophageal columnar mucosa) is dependent on correctly locating esophageal landmarks such as the gastroesophageal junction (GEJ). Lack of simple, standardized criteria for identifying these landmarks and reliably measuring the extent of Barrett’s esophagus has hindered consistency in research and clinical practice. Accordingly, a variety of ad hoc and frequently inadequately specified and validated approaches have been used. For instance, grading of patients into those with variably defined ‘short’ and ‘long’ segments of BE is an unsatisfactorily crude approach. An international Barrett’s esophagus working group was convened to standardize the endoscopic measurement of Barrett’s esophagus. The working group developed criteria to assess the circumferential and the maximal extent of esophageal columnar tissue, the Prague C and M criteria. Using these criteria, circumferential Barrett’s esophagus extending to 3 cm above the GEJ with a tongue extending 5 cm above the GEJ would be described as C3M5, while a tongue extending 3 cm above the GEJ with no circumferential extent of Barrett’s esophagus would be designated C0M3.

» Read more

 Brainteaser/image of the month

by Bjorn Rembacken

This is the duodenal cap of a 55 year old man undergoing gastroscopy for dyspepsia. He used to drink 1-2 glasses of wine each day but has recently reduced his alcohol intake as he found it to exacerbate his symptoms. He finished a one month course of a proton pump inhibitor six weeks earlier.The symptoms which settled with the therapy are now returning.

What is the most likely reason for the mucosal appearance in the duodenal cap?

a) gastric metaplasia

b) intestinal metaplasia

c) scarring from previous ulceration

d) hyperplastic polyps

e) duodenal adenoma

» Click Here for the Answer and Explanation

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