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Live demonstrations are traditional and popular methods of teaching practical digestive endoscopy. They enable the attendees to observe and interact with experts who are making decisions without hindsight in the same manner as in normal endoscopic practice. Unexpected findings and practical difficulties encountered are addressed and overcome, emphasizing the importance of keeping calm and adopting a methodical approach when under pressure. Never-the-less criticisms have been expressed that patients may be disadvantaged by agreeing to examination by a visiting specialist perhaps using unfamiliar equipment and in circumstances where the normal clinical lines of responsibility may be impaired. The endoscopic community therefore has a moral and legal responsibility to ensure that each patient's welfare is protected.
| Live demonstrations are traditional and popular methods of teaching practical digestive endoscopy. They enable the attendees to observe and interact with experts who are making decisions without hindsight in the same manner as in normal endoscopic practice. Unexpected findings and practical difficulties encountered are addressed and overcome, emphasizing the importance of keeping calm and adopting a methodical approach when under pressure. Never-the-less criticisms have been expressed that patients may be disadvantaged by agreeing to examination by a visiting specialist perhaps using unfamiliar equipment and in circumstances where the normal clinical lines of responsibility may be impaired. The endoscopic community therefore has a moral and legal responsibility to ensure that each patient's welfare is protected. |
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In November 2009, Dr Kenneth Wang took over the OMED Standards & Guidelines Committee, formerly lead by Dr David Bjorkman. This committee masterminded the successful OMED Endoscopy Directors´ Workshop (EDW) and Dr Wang plans to develop this format further, introduce new modules to the existing curriculum and expand teaching activities. OMED EDWs focus on the concept of teamwork in the endoscopy unit while at the same time emphasising the importance of leadership. Participants are provided with the knowledge required to organise their endoscopy service, to develop their own protocols, quality assurance and training. Together, international and local faculty join forces to streamline each workshop to the requirements of each location. This year, EDWs will be held in Kuala Lumpur, Malaysia (September 19, 2010) and Guayaquil, Ecuador (October 1, 2010). OMED is committed to providing useful tools and guidelines in order to promote improved standards and training of endoscopy throughout the world. With Dr Wang chairing the Standards and Guidelines Committee, new themes and content will be identified and, in collaboration with other committees, Electronic Teaching and other exciting fields of modern teaching will be tackled.
The Evangelisches Krankenhaus was founded in 1849 and today is the teaching hospital of the University of Duesseldorf, employing 200 doctors and 700 nursing staff it offers more than 560 beds in 11 subspecialties. Special focus is put on diagnostic and therapeutic endoscopy. It has an excellent national and international reputation and only last year it hosted seven delegates from China to encourage international cooperation. It is every year that Professor Horst Neuhaus, director of the Department of Gastroenterolgy, hosts the International Endoscopy Symposium. The next course is scheduled to take place February 4-5, 2011.
Professor Horst Neuhaus, who is director of gastroenterology and endoscopy at the Evangelisches Krankenhaus in Düsseldorf, Germany, has an annual live course which draws over 1000 registrants. In the video taken during the course, Dr. Jacques Bergman from the Academic Medical Center in Amsterdam, Netherlands is performing a radio frequency ablation of Barrett's esophagus. This patient had a prior endoscopic submucosal dissection of a superficial mucosal esophageal carcinoma originating in the Barrett-lined segment. This procedure is intended to destroy the residual non-neoplastic Barrett's mucosa. Assisting Dr. Bergman is Dr. Schultz from Berlin. This HALO 360 device is a bipolar probe which contains multiple electrical wires in alternating sequence on an expandable balloon. The size of the balloon is an important factor in this ablation technique and is determined by use of a sizing balloon. The correct position of the HALO 360 is monitored by passing an endoscope just above the balloon. The preprogrammed electrical discharge lasts for 1-2 seconds following which the balloon on the HALO 360 deflates. The white necrotic slough which remains on the wall is scraped off with a hood on the tip of the endoscope, and following this manoeuvre, a second application of the HALO 360 is made. This technique has been replacing photodynamic therapy for ablation of Barrett's esophagus.
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, is 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
This e-newsletter promotes the activities of OMED. Web site: www.omed.org |
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