OMED - World Organisation of Digestive Endoscopy
OMED - World Organisation of Digestive Endoscopy
Issue 9 OMED E-Newsletter January 2010

 New OMED Governing Council

Dr Jerome Waye
Dr Jerome Waye,
OMED President

Under the presidency of Dr Jerome Waye, New York, USA, and with Dr Melvin Schapiro, Los Angeles, USA, as Secretary General, OMED is heading for a new quadrennium. The OMED General Assembly has elected a new council during GASTRO 2009 and is proud to introduce new members on the OMED Governing Council: Dr Kenneth Wang of Mayo Clinic, Rochester, USA will chair the OMED Standards & Guidelines Committee, and Dr Jeffrey Ponsky of Cleveland University Hospitals will preside over the Surgical Endoscopy Committee, formerly an ad-hoc committee. OMED also warmly welcomes Dr Roque Saenz from Clinica Alemana-Universidad del Desarrollo in Santiago, Chile, as chair of the newly initiated ad-hoc committee Electronic Media. With great impetus and enthusiasm these three committees will spearhead OMED endeavours to teach and promote Endoscopy worldwide.

» Please click here to view the new OMED Governing Council

In this issue
dot New OMED Governing Council
dot
OMED Outreach Program
dot
GASTRO 2009 –London, UK Review
dot Minimal Invasive Surgery
dot OMED Showcase:
Centers of Excellence
dot NYSGE:Post-ERCP Pancreatitis
dot Brainteaser/image of
the month
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 OMED Outreach Program

Dr Horst Neuhaus
Dr Horst Neuhaus

Several years ago, OMED developed the concept of the OMED Outreach Program with Dr James DiSario as the director. As a result of a region-by-region submission of the need for development of endoscopy services, Olympus donated equipment to upgrade endoscopy supplies to 2 units, located in Rosario, Argentina and Ouagadougou, Burkina Faso. These units have thrived and developed to the point where they now provide high level diagnostic and therapeutic endoscopy to patients in their area and have established teaching programs as well. OMED is currently giving special recognition to endoscopy units who sponsor endoscopists in underserved areas of the world to come to these units for training. OMED is also giving special recognition to individual physicians who travel to underserved areas to teach hands-on techniques of endoscopy to those who need teaching and development.

Prof. Horst Neuhaus is director of the Department of Gastroenterology of the Evangelisches Krankenhaus Düsseldorf which has earned the distinction of an OMED Center of Excellence. He has become the first recognized OMED Outreach Partner having extended free registration and housing to several endoscopists in the Middle East to attend his Workshop in Dusseldorf. We congratulate Prof. Neuhaus and his Center of Excellence for this generous consideration to reach out to the underserved areas of the world.

 GASTRO 2009 – London, UK Review

GASTRO 2009 – London, UK Review

GASTRO 2009 from November 21-25, 2009 drew a record total number of over 15,000 participants and a buzzing industry exhibition of 3.656 m2. OMED was particularly involved in the Learning Area and the Live Demonstration. The selection of cases for this program was well acknowledged by a filled auditorium. Carefully chosen experts at the three OMED Centers of Excellence performed a wide range of interesting cases and succeeded in informing, teaching, and entertaining the audience.

In the ESGE/OMED Learning Area, on Saturday and Sunday more than 330 delegates participated in the Hands-on training on biologic models, meeting the experts and practicing with state of the art endoscopic equipment and accessories. In the DVD Learning Centre the latest teaching material was shown on video screens in 18 stations. The Lecture Theatre was successful and lively discussions arose on various topics.

During GASTRO 2009 for the first time the OMED Research Award was presented. With this award OMED recognises the endeavours of endoscopists who have achieved an outstanding reputation for their contribution to new developments in the field of digestive endoscopy.

It gives us great pleasure to pass our warmest congratulations to Dr Reina Pai Bender for her study on “Transcolonic endoscopic cholecystectomy: A NOTES survival study in a porcine model” (Gastrointestinal Endoscopy, 2006), Dr Peter Mensink for his work on “Complications of double balloon enteroscopy: a multicenter survey” (Endoscopy, 2007) and Dr Teruyuki Usuba for his publication “Analysis of buried bumper syndrome after percutaneous endoscopic gastrostomy due to use of a button-type kit” (Digestive Endoscopy, 2007).

The next OMED Research Award will be presented during DDW 2010 in New Orleans.

 Minimal Invasive Surgery

Dr Jeffrey Ponsky
Dr Jeffrey Ponsky

Professor Alberto Montori chaired the OMED Ad hoc committee MIS 2005-2009.

The committee has focussed on combined flexible-rigid endoscopy and international relationships between laparoscopic surgeons and endoscopists with very encouraging results. These specialists have a very good interaction providing the recent exciting development in NOTES.

Several studies are in progress, such as: Needlescopic and transvaginal cholecystectomy; NOTES in Bariatric Surgery; Merging Technologies (rigiflex) and Transumbilical one single port.

Due to Professor Montori’s various activities during the past quadrennium the scope of this committee has expanded. It has now become a standing committee, the “Surgical Endoscopy Committee” and is chaired by Dr Jeffrey Ponsky, Cleveland, USA.

The newly formed Surgical Endoscopy Committee will continue the endeavours, seeking collaboration with scientific - surgical societies and preparing publications that will be presented during ICE2011 in Los Angeles, USA. Industrial cooperation is gaining more importance and a clear aim of the committee is to establish NOTES in clinical practice.

 OMED Showcase: Centers of Excellence

This month OMED highlights the Asian Institute of Gastroenterology in Hyderabad, India.

The Asian Institute of Gastroenterology is a tertiary referral center in Hyderabad, India, catering exclusively to gastroenterological patients. It has over 50 consultants in medical gastroenterology and surgical gastroenterology besides fully staffed support departments of anaesthesiology, diagnostic and interventional radiology, pathology, microbiology and blood bank. A well equipped and state-of–the-art basic science center is a new addition to the institute and research on various gastroenterology related issues are in progress.

The institute has 200 beds including 25 intensive care for medical and surgical patients. In the endoscopic unit which has been recognized as a Center of Excellence by OMED, the following procedures are carried out in addition to routine endoscopies: Colonoscopy, ERCP, endosonography, enteroscopy, manometry, capsule endoscopy, and extracorporeal shock wave lithotripsy (ESWL), and NOTES procedures. Between 180 and 200 endoscopic procedures are performed every day. In the year 2008 approximately 26,000 upper GI Endoscopy, 8,500 colonoscopies, 5,000 ERCPS, 1,300 endosonograms, 300 ESWL (900-1,000 sessions) and 200 enteroscopies were performed. A training program teaches endoscopists from India and abroad both the basic as well as advanced endoscopic therapeutic procedures. A simulator (GI Mentor) is provided to these trainees.

Regular transmission of endoscopic procedures is an important feature of the endoscopy unit and between 10 and 12 such transmissions are performed every year both within the country and abroad. Last year the Asian Institute of Gastroenterology was selected for live transmission of endoscopic procedures to the World Congress of Gastroenterology, held in London in November 2009. The Asian Institute of Gastroenterology has held several well attended and appreciated international workshops on therapeutic GI endoscopies in the last few years. The last one held in February 2009 was attended by over 2,000 delegates from India and abroad.

During the recent live course in India, Dr. Horst Neuhaus, Director of the Center of Excellence in Düsseldorf, Germany, demonstrates the use of a new baby cholangioscope that can be passed through a special therapeutic side viewing instrument

Video from Center of Excellence in Hyderabad, India under the direction of Dr. Nageshwar Reddy: During the recent live course in India, Dr. Horst Neuhaus, Director of the Center of Excellence in Düsseldorf, Germany, demonstrates the use of a new baby cholangioscope that can be passed through a special therapeutic side viewing instrument. The patient has an indeterminate stricture just below the hilus of the liver, and both right and left hepatic ducts are dilated. Dr. Neuhaus is being assisted by Dr. K.L. Goh from the Center of Excellence in Kuala Lumpur, Malaysia. Because the common bile duct could not be cannulated with the cholangioscope, it was necessary to perform a sphincterotomy: this procedure is demonstrated. Following sphincterotomy, this special cholangioscope can be passed up to and through the stricture at the hilum. The vascular pattern at the lesion was diagnostic of carcinoma which was proven by a biopsy taken through this instrument.

» View live demonstration video

The technique of Spirus small bowel enteroscopy is demonstrated by its inventor, Dr. Paul Ackerman from Rhode Island, USA

Video from Center of Excellence in Hyderabad, India under the direction of Dr. Nageshwar Reddy: The technique of Spirus small bowel enteroscopy is demonstrated by its inventor, Dr. Paul Ackerman from Rhode Island, USA. The Spirus overtube is demonstrated showing the spiral ledges which grip the small intestine and pleat the intestine on the device as the overtube is inserted in a rotatory fashion. The patient has hereditary hemorrhagic telangiectasia and has required multiple blood transfusions. It is the intention of this procedure to look deep into the small bowel and use electrothermal energy to treat the multiple bleeding sites. Dr. Douglas Howell from Maine, USA is assisting during this procedure. Once deep in the small bowel, Dr. Ackerman can treat the bleeding arteriovenous malformations in an attempt to ablate them. The overtube not only holds the position of the enteroscope in the small bowel, but it also maintains straightness of the small intestine. The overtube maintains its position in the small intestine while the enteroscope can be repeatedly taken out and replaced (for instance, when multiple polyps need to be removed). The telangiectasias are treated with the argon plasma coagulator during withdrawal of the instrument.

» View live demonstration video

» Click here to view the OMED Video library

 NYSGE: Post-ERCP Pancreatitis

By Seth A. Cohen, M.D. Beth Israel Medical Center

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 at the Marriott Marquis in New York during December 15-18, 2010.

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 ‘Post-ERCP Pancreatitis’ by Seth A. Cohen, M.D., Beth Israel Medical Center, USA.

Post-ERCP pancreatitis (PEP), along with failure to achieve technical success in all patients, remains the Achilles heel of therapeutic ERCP. In unselected series the rate of post-ERCP pancreatitis varies between 5 and 10 %; most of these cases are mild, but some are moderate and less commonly some are severe. Severe PEP is a devastating illness for the patient and the endoscopist, as well as a drain on resources. The question is what can be done to minimize post-ERCP pancreatitis.

» Read more

 Brainteaser/image of the month

This lesion was found in the descending colon of a patient undergoing colonoscopy for anaemia.

by Bjorn Rembacken

This lesion was found in the descending colon of a patient undergoing colonoscopy for anaemia.

What type of lesion is this?

a) hyperplastic polyp

b) tubular adenoma

c) tubulovillous adenoma

d) villous adenoma

e) serrated adenoma

» Click Here for the Answer and Explanation

 Additional Links

» OMED Events Calendar

» Resources

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