Techniques and Innovations in Gastrointestinal Endoscopy最新文献

{"title":"Endoscopic Repair for Sleeve Gastrectomy Leaks Is Associated With a High Rate of Leak Resolution","authors":"Khalid Fahoum ,&nbsp;Tamara Kahan ,&nbsp;Olivia Delau ,&nbsp;Matthew Fasullo ,&nbsp;Ki-Yoon Kim ,&nbsp;Lauren Khanna ,&nbsp;Gregory Haber ,&nbsp;Paresh C. Shah ,&nbsp;Tamas Gonda","doi":"10.1016/j.tige.2024.09.004","DOIUrl":"10.1016/j.tige.2024.09.004","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Staple line leaks following sleeve gastrectomy have significant morbidity and mortality. Endoscopic repair approaches are increasingly being used and studied, but follow-up time is limited, and more data are needed. Our primary aim was to describe long-term outcomes following repair; secondary aims were to compare repair approaches and assess factors associated with clinical success.</div></div><div><h3>METHODS</h3><div>We conducted an observational cohort study of patients who underwent endoscopic repair of a sleeve gastrectomy leak from 2017 to 2023 at our tertiary care center. Patients without available follow-up were excluded. Electronic medical records were reviewed to obtain baseline and clinical characteristics; long-term outcomes were ascertained from the electronic medical record and telephonic conversations with patients. Repairs were classified as drainage when transmural stents were placed and as closure when clips, sutures, and/or an intraluminal stent was placed.</div></div><div><h3>RESULTS</h3><div>A total of 30 patients were included. The majority were females (77%) and Whites (74%), with a median age of 41.0 years (IQR, 35.1-51.8 years). The majority of patients (70%) initially underwent drainage, while the rest underwent closure. Median follow-up time was 1.2 years (IQR, 0.6 -1.6 years). Success rates for the initial repair approach without crossover or requiring surgical repair were 71.4% for drainage and 22.2% for closure (<em>P</em> = 0.02). Overall, 24 (80%) patients had leak resolution at the last follow-up, and the median number of endoscopies was 3 (IQR, 2-4).</div></div><div><h3>CONCLUSION</h3><div>Our study demonstrates a high rate of long-term leak resolution following endoscopic repair of sleeve gastrectomy leaks. An initial drainage approach may be associated with higher clinical success, although this was not noted in the multivariable analysis. Prospective randomized multicenter studies are needed to further evaluate and compare repair approaches.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150897"},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Endoscopic Role and Indications of Through-the-Scope Tack and Suture System for Gastrointestinal Closure","authors":"Andrew Canakis ,&nbsp;Abdulhameed Al-Sabban ,&nbsp;Shayan S. Irani","doi":"10.1016/j.tige.2024.09.005","DOIUrl":"10.1016/j.tige.2024.09.005","url":null,"abstract":"<div><div>The development of endoscopic closure devices has revolutionized management options for gastrointestinal defects. The endoscopists’ toolbox has expanded from through-the-scope clips to over-the-scope clips and over-the-scope suturing. The over-the-scope devices are somewhat limited by the target location, maneuverability, and need for device withdrawal for application. The introduction of a novel through-the-scope helix tack suture system enhances the toolbox for defect closure as this device can provide closure throughout the gastrointestinal tract without the need for endoscope withdrawal. Its user-friendly design and compatibility with standard endoscopes allows for complex tissues approximation in challenging locations. Since its approval by the Federal Drug Agency in December 2020, studies have investigated its utility for all types of defects, including perforations, leaks, fistulas, endoscopic resections sites, and even stent fixation. In this review, we will investigate the versatility of this device to understand its role in primary defect closure.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150898"},"PeriodicalIF":1.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Transpapillary Gallbladder Drainage With 2 Stents Versus 1 Stent Reduces Reinterventions: A Multicenter Study","authors":"James D. Haddad ,&nbsp;Natalie Wilson ,&nbsp;Vijay S. Are ,&nbsp;Shawn L. Shah ,&nbsp;Danny Issa ,&nbsp;Tarek Sawas ,&nbsp;Mohammad Bilal ,&nbsp;Thomas Tielleman","doi":"10.1016/j.tige.2024.09.006","DOIUrl":"10.1016/j.tige.2024.09.006","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Endoscopic transpapillary gallbladder drainage (ETGBD) is a therapeutic option for gallstone-related gallbladder disease in nonsurgical candidates. However, the optimal stenting strategy and follow-up has not been established. We aimed to determine whether there was a decreased need for unplanned reintervention in patients undergoing placement of two transpapillary gallbladder stents compared with that in those undergoing placement of one stent.</div></div><div><h3>METHODS</h3><div>We performed a multicenter retrospective analysis of patients undergoing ETGBD between June 2013 and October 2022. The primary outcome was clinical success as defined by resolution of symptoms without the need for another drainage strategy. Secondary outcomes included the adverse events of postendoscopic retrograde cholangiopancreatography pancreatitis, cholangitis, bleeding, perforation, or death. Factors associated with placement of two stents, unplanned reintervention, and adverse events were assessed.</div></div><div><h3>RESULTS</h3><div>We included 75 patients who underwent ETGBD, with a median follow-up of 407 days (IQR: 71-1504 days). Technical and clinical success were 88.2% and 81.3%, respectively. Unplanned reintervention was significantly lower in the double stenting group (0% vs 25.4%; <em>P</em> = 0.02). Use of a 7 French stent (odds ratio [OR]: 15.5; 95% CI: 1.9-125; <em>P</em> = 0.01) and presence of a percutaneous cholecystostomy tube (OR: 10.8; 95% CI: 2.8-41.3; <em>P</em> = 0.001) were associated with placement of two stents. There was no significant difference in adverse events between groups (OR: 0.9; 95% CI: 0.09-8.8; <em>P</em> = 0.94).</div></div><div><h3>CONCLUSION</h3><div>ETGBD is safe and effective in nonoperative candidates. Single transpapillary gallbladder stenting is associated with more unplanned reinterventions, and 7 French stent diameter and previous percutaneous cholecystostomy tube may be associated with ability to place a second stent. Endoscopists should consider planned exchange of solitary transpapillary gallbladder stents or interval placement of a second stent if placement of two stents was unsuccessful at the index procedure.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150899"},"PeriodicalIF":1.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Cancer Screening: A Narrative Review","authors":"Jihane Meziani,&nbsp;Gwenny M. Fuhler,&nbsp;Marco J. Bruno,&nbsp;Djuna L. Cahen,&nbsp;Kasper A. Overbeek","doi":"10.1016/j.tige.2024.08.001","DOIUrl":"10.1016/j.tige.2024.08.001","url":null,"abstract":"<div><div>Pancreatic cancer (PC) is one of the most lethal cancer types. Despite advancements that have led to some modest improvements in survival rates over the past decade, PC still has a dismal prognosis. Patients diagnosed with early-stage disease have higher survival rates. Unfortunately, PC seldom manifests itself early, and symptoms prompting diagnostic investigations usually develop when the disease is already advanced. PC screening may lead to better patient outcomes through detection of asymptomatic early-stage cancers and precursor lesions. Population-based screening is deemed unfeasible because of the low incidence of PC. However, screening of individuals with an inherited lifetime risk of ≥5%-10% for developing PC may prove beneficial. In the context of high-risk individuals, screening is referred to as surveillance. Yet, critical aspects such as suitable candidates for surveillance, the ideal time to initiate and discontinue surveillance, as well as the most effective surveillance method, preferred surveillance modalities, and optimal surveillance interval remain unclear. Herein, we summarize the current state of knowledge regarding PC surveillance by reviewing current expert consensus statements and guidelines. In addition, we review the management of identified lesions, the yield in different cohorts, and future directions to improve the outcomes of individuals at high-risk of developing PC.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 4","pages":"Pages 323-334"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533795","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":"Reducing the Carbon Footprint of Colorectal Cancer Screening","authors":"Swapna Gayam ,&nbsp;Aasma Shaukat","doi":"10.1016/j.tige.2024.03.006","DOIUrl":"https://doi.org/10.1016/j.tige.2024.03.006","url":null,"abstract":"<div><p>Climate change is the largest public health threat of the 21st century. Gastrointestinal endoscopy is the second overall waste generator and third highest hazardous waste generator in a hospital setting, making it essential for all gastroenterologists to reexamine their practices to reduce this negative impact. Colorectal cancer (CRC) is a major contributor to the gastrointestinal disease burden, and CRC screening is a vital component of age-appropriate cancer screening in the United States. Along the spectrum of colon cancer screening methods, considerations regarding their environmental impact are gaining prominence. Consequently, focusing mitigation strategies on CRC screening is justified. Mitigation strategies focused on CRC screening are likely to have a measurable impact on reducing the environmental impact of endoscopy, given the stark volume of procedures performed in the United States. In this paper, we review the different CRC screening options and strategies to reduce the environmental impact of these processes.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 2","pages":"Pages 193-200"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590030724000205/pdfft?md5=7584464c43c9e215d3f8b0814d130d0c&pid=1-s2.0-S2590030724000205-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140647020","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":"Semaglutide Is an Independent Predictor of Retained Solid Gastric Contents, but Same-Day Colonoscopy Mitigates Effect","authors":"Haarika Korlipara ,&nbsp;Jason Chua ,&nbsp;Adam Buckholz ,&nbsp;Jacob Jamison ,&nbsp;Ariel Gonzalez ,&nbsp;Sonal Kumar ,&nbsp;Marissa Weber ,&nbsp;Sanjay Salgado ,&nbsp;Reem Sharaiha ,&nbsp;Carolyn Newberry","doi":"10.1016/j.tige.2024.07.001","DOIUrl":"10.1016/j.tige.2024.07.001","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Glucagon-like peptide-1 receptor agonists are commonly prescribed for diabetes and obesity; however, their use may complicate anesthetized procedures due to delayed gastric emptying. This study sought to define rates of retained solid gastric contents, a risk factor for periprocedural complications, in a population taking semaglutide.</div></div><div><h3>METHODS</h3><div>This is a retrospective cohort study comparing individuals undergoing upper endoscopy over a 5-year period at a tertiary care center who were prescribed semaglutide, a long-acting glucagon-like peptide-1 receptor agonist, for &gt;4 weeks against a matched control cohort not on the medication. Multivariant logistic regression and multivariable propensity-matched association analysis were conducted to compare outcomes of interest, including retained solid gastric contents, endoscopic complications, and endoscopic outcomes.</div></div><div><h3>RESULTS</h3><div>In total, 1212 patients comprised the study population (602 on semaglutide, 610 not on semaglutide). On multivariant logistic regression analyzing causes of delayed gastric emptying, semaglutide was an independent risk factor for retained solid gastric contents (odds ratio [OR], 4.74; 95% CI, 2.40-9.35; <em>P</em> &lt; 0.0001). On multivariable propensity-matched association analysis utilizing demographic and clinical characteristics, semaglutide use was associated with an absolute increase of 6% of retained solid gastric contents (coefficient, 0.0644; 95% CI, 0.034-0.095; <em>P</em> &lt; 0.0001). Same-day colonoscopy was protective against this finding (OR, 0.41; 95% CI, 0.23-0.73; <em>P</em> = 0.003). Intubation was rare and not associated with semaglutide use (OR, 0.70; 95% CI, 0.30-1.64; <em>P</em> = 0.41). No periprocedural aspiration events occurred.</div></div><div><h3>CONCLUSION</h3><div>Semaglutide was an independent risk factor for retained solid gastric contents, even when accounting for confounding factors. This was negated in patients undergoing same-day colonoscopy, indicating an opportunity for preprocedural fasting protocols in the absence of medication hold.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 4","pages":"Pages 316-322"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Step-Up Strategy for Endoscopic Hemostasis Using PuraStat After Endoscopic Sphincterotomy Bleeding (STOP Trial)","authors":"","doi":"10.1016/j.tige.2024.03.005","DOIUrl":"10.1016/j.tige.2024.03.005","url":null,"abstract":"<div><h3>Background and Aims</h3><p><span>Recently, a novel self-assembling peptide hemostatic<span> gel (PuraStat) has become available. Although PuraStat for endoscopic sphincterotomy (EST) bleeding has been evaluated and reported mainly in case reports and several retrospective studies, no prospective evaluation has been reported. The aim of the present study was to prospectively evaluate the safety and efficacy of PuraStat for persistent EST bleeding &gt;120 seconds as a first-line endoscopic </span></span>hemostasis technique.</p></div><div><h3>Methods</h3><p>This single-arm, prospective study was conducted between November 2022 and August 2023. As the primary technique for endoscopic hemostasis, PuraStat was applied first. If hemostasis failed, other techniques were used. The primary outcome of the present study was to evaluate the technical success rate of the application of PuraStat to the bleeding site. Clinical success was defined as the absence of oozing for 180 seconds after PuraStat application. Adverse events associated with procedures and secondary hemorrhage were secondary outcomes. PuraStat application was performed using the embankment method.</p></div><div><h3>Results</h3><p><span>During the study period, 1080 endoscopic retrograde cholangiopancreatography procedures were performed. A total of 108 patients experienced complications with EST bleeding. Among them, endoscopic hemostasis was required in 51 patients. These patients enrolled in this prospective study. All patients successfully underwent PuraStat application without PuraStat dislocation into the third part of the </span>duodenum. The technical success rate of endoscopic hemostasis using PuraStat was 98% (50/51). As possible factors associated with secondary hemorrhage, biliary stents, including plastic or metal stents, were deployed in 60.7% (31/51). Finally, severe adverse events associated with the procedures were not observed in any patients, although mild acute pancreatitis was observed in 2 patients, and conservative treatment was successful.</p></div><div><h3>Conclusion</h3><p>In conclusion, PuraStat application may be safe for oozing after EST without increasing the frequency of acute pancreatitis.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 3","pages":"Pages 224-229"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sphincterotomy vs Sham Procedure for Pain Relief in Sphincter of Oddi Dysfunction: Systematic Review and Meta-analysis","authors":"Dennis Wang,&nbsp;Kayla Dadgar,&nbsp;Mohammad Yaghoobi","doi":"10.1016/j.tige.2023.10.003","DOIUrl":"10.1016/j.tige.2023.10.003","url":null,"abstract":"<div><h3>Background and Aims</h3><p><span><span>Endoscopic sphincterotomy (ES) used to be part of </span>sphincter of Oddi dysfunction (SOD) management, but recent studies changed attitudes about its utility. We conducted a </span>systematic review and meta-analysis of randomized sham-controlled trials (RCTs) investigating ES for biliary SOD-related pain.</p></div><div><h3>Methods</h3><p>Articles were retrieved from PubMed, Medline, Embase, and CENTRAL. We included RCTs comparing ES with a sham procedure<span> on post-cholecystectomy patients ≥18 years old with biliary SOD. Standardized data collection sheets were used, as well as the Risk of Bias 2 tool. A random-effects model was used to calculate risk ratios (RRs) with 95% confidence intervals (CIs). Subgroups included normal vs abnormal sphincter of Oddi manometry (SOM) and type II vs III SOD.</span></p></div><div><h3>Results</h3><p>From 517 articles retrieved, 4 RCTs were included, encompassing 376 patients. Overall, no difference existed between ES and the sham procedure in improving biliary SOD-related pain overall (RR 1.32, 95% CI 0.77-2.26, <em>P</em> = .31) and for the normal (RR 0.83, 95% CI 0.42-1.65, <em>P</em> = .60) and abnormal SOM subgroups (RR 1.90, 95% CI 0.84-4.29, <em>P</em><span> = .12). ES was numerically favored over the sham procedure in patients with type II (RR 2.51, 95% CI 1.32-4.81, </span><em>P</em> = .005) but not type III SOD (RR 1.02, 95% CI 0.32-3.27, <em>P</em> = .98). However, there was no significant subgroup difference between these type-based subgroups (<em>P</em> = .18, I² = 43.2%).</p></div><div><h3>Conclusion</h3><p>ES does not improve biliary SOD-related pain overall or for type II vs III SOD or normal vs abnormal SOM subgroups. This meta-analysis confirms that there is no proven role for SOM or ES in managing SOD.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 1","pages":"Pages 30-37"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135564556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preface: Optimizing and Sustaining High-Quality Colorectal Cancer Screening","authors":"Audrey H. Calderwood","doi":"10.1016/j.tige.2024.03.002","DOIUrl":"10.1016/j.tige.2024.03.002","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 2","pages":"Page 93"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140277571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outside the Training Paradigm: Challenges and Solutions for Endoscopy Provision in Resource-Limited Settings","authors":"Sandie Thomson ,&nbsp;Chris Hair ,&nbsp;Ganiyat Kikelomo Oyeleke","doi":"10.1016/j.tige.2024.06.002","DOIUrl":"10.1016/j.tige.2024.06.002","url":null,"abstract":"<div><p>Limited-resource settings pose problems for the provision of health services. Experience with the challenges of the provision of endoscopy services and potential solutions are presented by authors who have taught and practiced in such settings in Africa and the Pacific Islands. The concept of limited-resource settings is defined in the context of health services in general. The situation regarding endoscopy provision details and discusses the unique challenges of manpower, endoscopy facilities, endoscope and accessory equipment inventory, and endoscopy reporting. Health services quality is related to wealth and how it is deployed. Simplistically wealth means health, and poverty illness. Low-income and Low middle–income countries have the biggest challenges. One is the health professional workforce. The number of gastroenterologists per 100,000 in South Africa, an upper middle–income country, is 0.33 compared with 3.9 in the United States. Hence, endoscopy provision is by general surgeons and physicians. Upper and lower gastrointestinal endoscopic capacity in East Africa was 106 and 45 procedures per 100,000 persons per year, respectively which is &lt;10% of that reported from high-income countries. Outside major teaching hospitals, most endoscopy is practiced in uncustomized single rooms often in a surgery complex. Endoscope inventory is more expensive than in the United States as is maintenance and repair as they are out of the country resulting in many units being below the minimum requirements to run a sustained service. Electronic reporting systems are few and not standardized. The World Gastroenterology Organisation and the World Endoscopy Organization should be the overarching advocates to support public–private partnerships and develop solutions for sustainable inventory acquisition. Endoscopy must be monitored electronically to assess procedural competency and provide desperately needed information to influence health policy.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 3","pages":"Pages 270-282"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590030724000369/pdfft?md5=16b264d7200da4b5e6f4191afde07f65&pid=1-s2.0-S2590030724000369-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950405","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}