iGIE最新文献

{"title":"Endosonography-guided suture device for gastrointestinal lumen-to-lumen apposition in a porcine model","authors":"Jad AbiMansour MD,&nbsp;Shunsuke Kamba MD,&nbsp;Barham K. Abu Dayyeh MD,&nbsp;Ryan J. Law DO,&nbsp;Vinay Chandrasekhara MD,&nbsp;Elizabeth Rajan MD,&nbsp;Andrew C. Storm MD","doi":"10.1016/j.igie.2024.08.009","DOIUrl":"10.1016/j.igie.2024.08.009","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The ability to effectively tether 2 separate lumens would simplify performance of transluminal therapeutic endoscopic ultrasound (EUS). This article describes a novel device permitting simple and effective luminal apposition under EUS guidance.</div></div><div><h3>Methods</h3><div>A porcine preclinical study using 1 domestic pig was performed to show proof-of-concept of a novel suturing device that can be deployed with EUS to appose the gallbladder wall to the stomach. The goal is to facilitate a simple and straightforward approach to cholecystogastrostomy using a lumen-apposing metal stent.</div></div><div><h3>Results</h3><div>EUS was performed to identify the porcine gallbladder. The device was used to puncture across the gastric wall and into the gallbladder. Once needle access was obtained, 4 flexible braided suture tags were extruded over a 3-0 polypropylene suture into the gallbladder lumen. Upon applying suture tension, the tags bunch to form a secure loop within the gallbladder lumen. With tension on this suture, the gallbladder may be brought up to the gastric wall and the transmural 3-0 suture then cinched at the gastric mucosa to effect durable luminal apposition. After this, cholecystogastrostomy with an electrocautery-enhanced lumen-apposing metal stent was performed using a standard freehand technique.</div></div><div><h3>Conclusions</h3><div>A novel EUS-guided suturing device permits apposition of the porcine gallbladder and stomach, facilitating EUS-guided transmural gallbladder drainage. This approach may affect the safety and technical success rates of novel translumenal therapeutic EUS procedures.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the effectiveness of Chat-GPT 4.0, an artificial intelligence conversational tool, for addressing common patient queries in gastrointestinal endoscopy","authors":"Giulio Calabrese MD ,&nbsp;Roberta Maselli MD, PhD ,&nbsp;Marcello Maida MD ,&nbsp;Federico Barbaro MD, PhD ,&nbsp;Rui Morais MD ,&nbsp;Olga Maria Nardone MD, PhD ,&nbsp;Emanuele Sinagra MD, PhD ,&nbsp;Roberto Di Mitri MD ,&nbsp;Sandro Sferrazza MD","doi":"10.1016/j.igie.2025.01.012","DOIUrl":"10.1016/j.igie.2025.01.012","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Chat Generative Pre-Trained Transformer (Chat-GPT) has proven effective in addressing patient inquiries related to gastrointestinal (GI) disease. We aimed to assess the effectiveness and reliability of Chat-GPT in answering common patients’ queries on GI endoscopy.</div></div><div><h3>Methods</h3><div>Eighteen selected patients’ queries regarding GI endoscopy were rated on a Likert-type scale by 10 health professionals and 2 non-health professionals on the following features: reliability (1-6), accuracy (1-3), and comprehensibility (1-3).</div></div><div><h3>Results</h3><div>The mean reliability, accuracy, and comprehensibility values were 5.2 ± 1.7, 2.7 ± 0.4, and 2.9 ± 0.2, respectively. Overall, most answers were rated as having a solid level of reliability (94.4%) and accuracy (100%) and fair levels of comprehensibility (61.1%). The physicians considered the tool to be adequate for addressing questions related to clinical practice, except for inquiries regarding bowel prep solutions, medications, and pacemaker management.</div></div><div><h3>Conclusions</h3><div>Chat-GPT 4.0 demonstrated effectiveness in providing patients with informative content about GI endoscopy, even though health professional support remains essential for a comprehensive approach.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 21-25"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Freedom to innovate: the story of natural orifice translumenal endoscopic surgery and the endoscopic suturing device","authors":"Sergey V. Kantsevoy MD, PhD, FJGES ,&nbsp;Phillip S. Ge MD, FASGE","doi":"10.1016/j.igie.2025.01.014","DOIUrl":"10.1016/j.igie.2025.01.014","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 78-103"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On behalf of our editors, authors, and readers: A tribute to our reviewers","authors":"","doi":"10.1016/j.igie.2024.11.001","DOIUrl":"10.1016/j.igie.2024.11.001","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Page 567"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a machine learning–based prediction model on annual surveillance endoscopy costs for detecting gastric cancer","authors":"Junya Arai MD, PhD ,&nbsp;Atsushi Miyawaki MD, PhD ,&nbsp;Yoku Hayakawa MD, PhD ,&nbsp;Tomonori Aoki MD, PhD ,&nbsp;Ryota Niikura MD, PhD ,&nbsp;Hiroaki Fujiwara MD, PhD ,&nbsp;Tetsuo Ushiku MD, PhD ,&nbsp;Masato Kasuga MD, PhD ,&nbsp;Mitsuhiro Fujishiro MD, PhD","doi":"10.1016/j.igie.2024.09.003","DOIUrl":"10.1016/j.igie.2024.09.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>In this study, we assessed our machine learning (ML)-based model's impact on reducing annual surveillance endoscopy costs for detecting gastric cancer (GC).</div></div><div><h3>Methods</h3><div>We analyzed 1099 patients with chronic gastritis undergoing annual EGD and randomly divided them into training and test sets (4:1). Using gradient-boosting decision trees and incorporating patient characteristics, we developed the ML model. In the test sets, we compared the EGD number needed to screen (NNS) for 1 GC, cost, and GC detection rate across different risk stratification strategies.</div></div><div><h3>Results</h3><div>The ML-selected high-risk cohort demonstrated low NNS values, low total cost, low cost per 1 GC, and high GC detection rates compared with alternative risk stratification approaches, including operative link for gastric atrophy assessment and operative link for gastric intestinal metaplasia assessment.</div></div><div><h3>Conclusions</h3><div>Our ML model holds promise in reducing endoscopy surveillance costs while maintaining a robust GC detection rate.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Pages 463-467"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep sight: enhancing periprocedural adverse event recording in endoscopy by structuring text documentation with privacy-preserving large language models","authors":"Isabella C. Wiest MD, MSc ,&nbsp;Dyke Ferber MD ,&nbsp;Stefan Wittlinger MSc ,&nbsp;Matthias P. Ebert MD ,&nbsp;Sebastian Belle MD ,&nbsp;Jakob Nikolas Kather MD, MSc","doi":"10.1016/j.igie.2024.08.001","DOIUrl":"10.1016/j.igie.2024.08.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The assessment of adverse events from endoscopic procedures is essential for successful interventions, ensuring accurate follow-up, adverse event management, and processing for quality control. Despite the critical need for structured documentation, the current practice often relies on free-text recordings, which poses challenges for scalable intervention analysis; however, the introduction of large language models (LLMs) offers a promising solution by enabling the automatic extraction of adverse event details from procedural reports without altering existing documentation practices.</div></div><div><h3>Methods</h3><div>We analyzed 672 endoscopy reports, using OpenAI’s GPT-4 and Llama-2–based models to structure the data in JavaScript Object Notation for efficient analysis. We used an automated LLM pipeline to extract adverse events such as bleeding, perforation, and aspiration. The dataset was divided into a proof-of-concept set (PoC-S) with n = 171 reports, on which we explored prompt engineering to improve the performance of the models. The final analysis was run on an additional external test set of 501 reports.</div></div><div><h3>Results</h3><div>GPT-4 showed high accuracy, with a sensitivity of 97% and specificity of 92% in the PoC-S and 91% and 96%, respectively, in the test set. GPT-4 use in real-world settings is limited by privacy concerns. Conversely, Llama-2–based models, especially the Llama-2 variants fine-tuned for German language, demonstrated comparable performance (PoC-S: sensitivity of 94%; specificity of 92%, in the test set (TS): sensitivity of 89%; specificity of 93%) and offered a viable privacy-compliant alternative. The model effectiveness was further influenced by the method of prompt engineering, with experiments showing that the specificity and sensitivity could vary substantially based on the inclusion of specific prompt features, underscoring the importance of tailored prompt design.</div></div><div><h3>Conclusions</h3><div>Applying LLMs to extract structured medical information, particularly from endoscopy reports, offers an efficient, scalable, and adaptable documentation method that captures adverse events accurately with a low error rate. It facilitates immediate quality reporting and reduces manual documentation efforts.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Pages 447-452.e5"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of over-the-scope endoscopic suturing device for closure of defects after endoscopic submucosal dissection: a systematic review and meta-analysis","authors":"Tahne Vongsavath DO ,&nbsp;Kyaw Min Tun DO ,&nbsp;Syed Mohsin Saghir MD ,&nbsp;Jay Bapaye MD ,&nbsp;Renuka Verma MD ,&nbsp;Chun-Han Lo MD ,&nbsp;Ahmad Gill MD ,&nbsp;Banreet Singh Dhindsa MD ,&nbsp;Saurabh Chandan MD ,&nbsp;Douglas G. Adler MD, FACG, AGAF, FASGE","doi":"10.1016/j.igie.2024.09.007","DOIUrl":"10.1016/j.igie.2024.09.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopic submucosal dissection (ESD) is used for closure of GI lesions after endoscopic resection techniques such as EMR. Generally, a large defect is left that can increase the risk of postprocedural bleeding or perforation, and it has been managed by techniques such as endoscopic placement of clips to reapproximate the defect edges. An over-the-scope suturing system (OSS), OverStitch created by Apollo Endosurgery, has been designed for similar utility in ESD closure. The goal of its design is to achieve full-thickness closure and exchange of suture without endoscopic removal. The goal of this study was to evaluate the technical success and efficacy of using OSS in the closure of ESD.</div></div><div><h3>Methods</h3><div>A comprehensive literature review across multiple databases was performed. Studies including OverStitch and ESD information were evaluated, with 7 articles meeting predetermined eligibility of quality for inclusion. Statistical analysis was completed by using CMA version 3.0 software (Biostat, Englewood, NJ, USA). The primary evaluated end point was technical success and efficacy of instrument use in patients undergoing ESD closure with OSS. The secondary evaluated end point was the overall rate of adverse events related to the use of OSS.</div></div><div><h3>Results</h3><div>Overall, the pooled rates for instrumental efficacy and technical success were 95.8% (95% CI [confidence interval], 80.6%-99.2%; <em>P</em> = .04) and 99.2% (95% CI, 79.8%-100.0%; <em>P</em> = 1.00), respectively. The pooled rate of adverse events was .9% (95% CI, 0%-24.8%; <em>P</em> = .99) with pain reported as the most common adverse event.</div></div><div><h3>Conclusions</h3><div>OSS seems to be an effective and safe tool in the closure of defects after ESD. However, its design also makes it large and difficult to maneuver. Although it allows for replacement of the suture kit without endoscopic removal, there have been multiple reported episodes of device failure. Further randomized controlled trials are warranted as OSS becomes more widely used.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Pages 527-532.e2"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel endoscopic suturing device: comparison with endoclips and hand-sewn techniques for gastrostomy closure in an ex vivo porcine model","authors":"Jun Hee Lee MD ,&nbsp;Ji Yoon Kim MD ,&nbsp;Taebin Kwon MS ,&nbsp;Hyuk Soon Choi MD, PhD ,&nbsp;Bora Keum MD, PhD ,&nbsp;Hoon Jai Chun MD, PhD ,&nbsp;Daehie Hong PhD ,&nbsp;Hyunsoo Chung MD, PhD","doi":"10.1016/j.igie.2024.10.004","DOIUrl":"10.1016/j.igie.2024.10.004","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Pages 487-489"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing peritoneal visualization in peroral endoscopic myotomy with fundoplication using novel robotic peritoneal pressure optimization","authors":"Ayah Matar MD,&nbsp;Farimah Fayyaz MD,&nbsp;Preethi Jagannath MD,&nbsp;Jose Antonio Almario MD,&nbsp;Mouen Khashab MD","doi":"10.1016/j.igie.2024.09.005","DOIUrl":"10.1016/j.igie.2024.09.005","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Pages 470-472"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected clipping failure of a full-thickness resection device during endoscopic full-thickness resection","authors":"Yasutoshi Shiratori MD, MPH, PhD ,&nbsp;Aaron Tokayer MD ,&nbsp;Anthony Kalloo MD","doi":"10.1016/j.igie.2024.08.006","DOIUrl":"10.1016/j.igie.2024.08.006","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Pages 475-477"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}