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Create a Free AccountProcedures - Upper endoscopy (EGD)
Endoscopic reduction of type IV paraesophageal hernia
Type IV paraesophageal hernias are characterized by upward dislocation of the intra-abdominal organs into the thoracic cavity and the presence of a structure other than the stomach within the hernia sac. Although surgical repair is traditionally indicated in symptomatic patients with a paraesophageal hernia, limited options are available for patients deemed to be high risk for surgical repair.1,2 In this video (Video 1, available online at VideoGIE.org ), we describe a successful case of endoscopic type IV paraesophageal hernia reduction in a patient who was not able to undergo surgical repair.Emerging therapies in translational endoscopy: new frontiers in endoscopic submucosal dissection
The field of therapeutic endoscopy is evolving with a variety of new endoscopic surgical procedures. One such procedure, endoscopic submucosal dissection (ESD), has proven efficacy, yielding high margin-negative (R0) resection rates with low rates of adverse events and recurrence.1 However, the technical complexity, long procedure duration, and steep learning curve associated with ESD have led to relatively slow adoption. Although there has been an increased trend in devices and tools that may assist with ESD, there remains a paucity of advances in endoscopic technology, which are much needed given these known barriers.Endoscopic submucosal dissection of esophageal metastatic melanoma
A 65-year-old man underwent surgical excision with lymph node dissection for a scalp melanoma in 2011. In 2018, he presented to his melanoma oncologist for routine follow-up and subsequently underwent an upper endoscopy for reflux symptoms. His upper endoscopy revealed a pigmented lesion in the esophagus, biopsy specimens that showed malignant melanoma. Positron emission tomography/CT and magnetic resonance imaging of the brain revealed no evidence of distant metastases. He was referred for further endoscopic evaluation and treatment.Subpyloric tunneling endoscopic submucosal dissection: a novel technique for safe and successful removal of a challenging duodenal submucosal lesion
Owing to their anatomic location, submucosal lesions in the proximal duodenal bulb can be challenging to resect by EMR. Here, we present a novel endoscopic submucosal dissection (ESD) technique for successful removal of a duodenal submucosal lesion (Video 1, available online at www.VideoGIE.org ).Multi-bypass with the use of lumen-apposing metal stents to maintain luminal continuity of the GI tract in a patient with altered anatomy
The goal of endoscopic palliative therapies is to provide improvement in quality of life with minimal morbidity and mortality. Surgery has been the primary treatment for malignant obstruction, although surgical morbidity is higher in emergency scenarios. Stent placement is commonly used in malignant and benign GI obstruction with established efficacy and safety.1,2 Lumen-apposing metal stents (LAMSs) represent an evolution in endoscopic stents and are considered a disruptive change in therapeutic endoscopy.
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