VideoGIE最新文献

{"title":"Approach to management of bleeding during EUS-guided liver biopsy: salvage therapy using absorbable gelatin sponge","authors":"Frances Dang MD, MSc ,&nbsp;David Cheung MD ,&nbsp;Michael Andrew Yu MD ,&nbsp;Usman Rahim MD ,&nbsp;Joshua Kwon MD ,&nbsp;Amirali Tavangar MD ,&nbsp;Jason Samarasena MD, MBA ,&nbsp;Kenneth Chang MD","doi":"10.1016/j.vgie.2025.02.013","DOIUrl":"10.1016/j.vgie.2025.02.013","url":null,"abstract":"<div><h3>Background and Aims</h3><div>EUS-guided liver biopsy (EUS-LB) has emerged as a reliable alternative to interventional radiology–guided biopsy, offering comparable specimen adequacy. Bleeding remains the most common adverse event. We describe a novel use of absorbable gelatin sponge slurry for hemostasis during EUS-LB and propose a stepwise management approach.</div></div><div><h3>Methods</h3><div>Liver biopsy was performed using a dynamic suction technique with a 19-gauge fine-needle biopsy needle. After biopsy, e-Flow Doppler was used to evaluate for bleeding. Since Doppler flow persisted, initial management included leaving the needle in place for 4 minutes and performing a blood patch technique. For bleeding extending beyond the liver capsule, a gelatin sponge slurry was prepared by macerating absorbable gelatin pledgets into a thick gel using the Tessari technique. The slurry was injected into the bleeding tract while withdrawing the needle under EUS guidance.</div></div><div><h3>Results</h3><div>Application of this stepwise approach during EUS-LB successfully achieved hemostasis without the need for surgical or radiologic intervention. The gelatin sponge slurry effectively sealed the bleeding tract, with no significant postprocedural hematoma or ongoing hemorrhage observed.</div></div><div><h3>Conclusions</h3><div>The use of an absorbable gelatin sponge slurry represents a promising salvage technique for managing bleeding during EUS-LB when conventional methods fail.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 7","pages":"Pages 364-367"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364700","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":"Saline immersion endoscopic submucosal dissection for management of early Barrett’s esophagus adenocarcinoma and large esophageal varices","authors":"Giuliano Francesco Bonura MD ,&nbsp;Thomas Veiser MD ,&nbsp;Tobias Dertmann MD ,&nbsp;Jorg Hollerich MD ,&nbsp;Mauro Manno MD ,&nbsp;Edward John Despott MD, FRCP, FEBGH, FASGE, MD (Res) ,&nbsp;Naohisa Yahagi MD, PhD ,&nbsp;Torsten Beyna MD, PhD","doi":"10.1016/j.vgie.2025.02.009","DOIUrl":"10.1016/j.vgie.2025.02.009","url":null,"abstract":"<div><h3>Background and Aims</h3><div>We report the case of a 65-year-old man who was referred to our unit with a diagnosis of a large early Barrett’s esophagus adenocarcinoma, extending for about 10 cm and involving two-thirds of the esophageal circumference. CT scan revealed a moderate esophageal variceal ectasia not visible at endoscopic evaluation; however, no sign of liver cirrhosis had been identified at abdominal ultrasound, elastography, and laboratory examinations. Therefore, after a preliminary discussion with the tumor board, we performed endoscopic submucosal dissection (ESD).</div></div><div><h3>Methods</h3><div>An ultraslim therapeutic endoscope (EG-840 TP Slim Treatment Gastroscope, Fujifilm, Tokyo, Japan) was used. This gastroscope has a 7.9-mm insertion tube endowed with a large 3.2-mm working channel and powered by an expanded angulation (210° up/160° down) that significantly improves maneuverability. Moreover, the latest-generation hybrid-knife (HYBRIDknife flex I-Type, Erbe, Tübingen, Germany) was used, further improving the cut and coagulate precision. The procedure was performed under amber-red-color imaging (Fujifilm) mode, specifically designed to enhance the visibility of deep vessels and submucosal space/muscle.</div></div><div><h3>Results</h3><div>Following significant bleeding after first mucosal incision at the distal margin, the initial therapeutic plan of tunnel creation method was changed, and a complete circumferential incision was performed followed by a submucosal dissection assisted by the saline-immersion technique and double clip-line traction method. Importantly, during ESD a dense network of marked dilated esophageal varices (up to 7 mm in diameter) were encountered in the third space, significantly prolonging the procedural time. However, varices were all preventively identified and treated. Finally, the lesion was resected en bloc, and no adverse events occurred. The patient was discharged home 3 days later asymptomatic, and histopathological evaluation revealed a curative intramucosal adenocarcinoma (pT1a, m2, L0, V0, Bd1, R0, G1) resection. At 3-month endoscopic follow-up, no significant stricture or residual/recurrence neoplastic lesion were observed.</div></div><div><h3>Conclusions</h3><div>ESD of Barrett's esophagus adenocarcinoma located at esophageal varices may be considered a viable option even without previous variceal treatment.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 7","pages":"Pages 345-348"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364692","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":"Transoral incisionless fundoplication as rescue therapy for gastroesophageal reflux in a lung transplant recipient","authors":"William King MD ,&nbsp;Hannah Zuercher MD ,&nbsp;Manuel Amaris MD ,&nbsp;Amir Emtiazjoo MD ,&nbsp;Mindaugas Rackauskas MD, PhD ,&nbsp;Bashar Qumseya MD, MPH","doi":"10.1016/j.vgie.2025.02.003","DOIUrl":"10.1016/j.vgie.2025.02.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>A patient with a prior lung transplant and surgical fundoplication had severe recurrent gastroesophageal reflux disease (GERD) and chronic retrograde microaspiration, which both threatened his graft function and elevated his risk for retransplant. He was deemed a poor candidate for surgical fundoplication. We therefore aimed to perform a transoral incisionless fundoplication (TIF).</div></div><div><h3>Methods</h3><div>The gastroesophageal flap valve was loose on diagnostic esophagogastroduodenoscopy. We used a plication device to repair the existing fundoplication, forming a 270°, 3-cm wrap using 12 H-type fasteners.</div></div><div><h3>Results</h3><div>Erosive esophagitis improved from Los Angeles grade C to A and acid exposure time from 30% to 5%. Heartburn symptoms resolved. He underwent repeat lung transplant.</div></div><div><h3>Conclusions</h3><div>The video in this case demonstrates the technique for TIF after surgical fundoplication. This case also supports the use of TIF as rescue therapy for post-lung transplant GERD.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 6","pages":"Pages 285-288"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946643","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":"Pancreas cystic lesion with surprise findings on confocal laser endomicroscopy","authors":"Ayah Matar MD ,&nbsp;Gregory Charville MD, PhD ,&nbsp;Maggie Lam MD ,&nbsp;Samer El-Dika MD","doi":"10.1016/j.vgie.2025.02.005","DOIUrl":"10.1016/j.vgie.2025.02.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The incidental diagnosis of pancreatic cystic lesions has been increasing, ranging from 2% to 45%, as determined by computed tomography or magnetic resonance imaging. This report describes the case of a 74-year-old female patient referred for a finding on magnetic resonance imaging of a unilocular cystic lesion in the pancreas tail.</div></div><div><h3>Methods</h3><div>Based on the cyst’s size and its unclear nature, the patient was subjected to a repeat EUS at our institution, which showed an anechoic 35 × 20-mm finely septated lesion in the pancreatic tail. To help determine the nature of the cyst, EUS-guided needle-based confocal laser endomicroscopy (EUS-nCLE) was used because of its ability to visualize the cyst wall mucosal layer to a micrometer resolution.</div></div><div><h3>Results</h3><div>EUS-nCLE of the cyst wall showed an intersecting network of vessels, with background arrangement of gray oval structures and at times background arrangement of dark lobular structures. The findings were not consistent with a mucinous pancreas cyst, serous cystadenoma, or cystic neuroendocrine tumor. As for the NGS, the cyst fluid was positive for both <em>KRAS</em> and <em>PIK3CA</em> pathogenic mutations. After the patient’s distal pancreatectomy, histologic examination of the lesion entirely revealed a vascular malformation. The lesion did not have a distinct wall and was surrounded by fat and pancreas tissue. This vascular malformation is a form of lymphangioma.</div></div><div><h3>Conclusion</h3><div>Lymphangiomas of the pancreas are rare, accounting for 0.2% of all pancreatic lesions. Targeted NGS performed at our institution on the surgical specimen showed absence of <em>KRAS</em> and <em>PIK3CA</em> mutations, suggesting an erroneous or false-positive initial analysis of the cyst fluid. The gray oval structures observed during EUS-nCLE correspond to adipocytes marking part of the cyst border. The dark lobular structures (coffee beans) observed during EUS-nCLE correspond to pancreatic acini marking another part of the cyst border. When these EUS-nCLE patterns are observed in a pancreas cystic lesion in the absence of any epithelial pattern, close follow-up with cross-sectional imaging should be considered instead, especially if the lesion is in a pancreas location that entails major surgery.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 6","pages":"Pages 299-301"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946646","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":"Diagnosing high-grade pancreatic intraepithelial neoplasia in surgically altered anatomy using pancreatic juice cytology","authors":"Soma Fukuda MD ,&nbsp;Susumu Hijioka MD, PhD ,&nbsp;Kohei Okamoto MD ,&nbsp;Shin Yagi MD ,&nbsp;Mark Chatto MD ,&nbsp;Yutaka Saito MD, PhD ,&nbsp;Takuji Okusaka MD, PhD","doi":"10.1016/j.vgie.2025.02.006","DOIUrl":"10.1016/j.vgie.2025.02.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Diagnosing early-stage pancreatic ductal adenocarcinoma, particularly high-grade pancreatic intraepithelial neoplasia (HG-PanIN), remains challenging. Serial pancreatic juice aspiration cytologic examination (SPACE) using an endoscopic nasopancreatic drainage tube has demonstrated high diagnostic accuracy, but its application in surgically altered anatomy is technically demanding. We present a case in which balloon enteroscopy-assisted SPACE led to the diagnosis of HG-PanIN and successful resection.</div></div><div><h3>Methods</h3><div>A 70-year-old man with a history of distal gastrectomy and Roux-en-Y reconstruction for gastric cancer underwent follow-up imaging, which revealed localized main pancreatic duct (MPD) stricture and parenchymal atrophy in the pancreatic tail. EUS identified a faint hypoechoic area around the stricture, but no distinct mass. EUS-guided tissue acquisition was inconclusive. Double-balloon enteroscopy-assisted endoscopic retrograde pancreatography was performed, revealing MPD stricture and distal dilation. A 5F endoscopic nasopancreatic drainage tube was placed across the stricture, and SPACE was conducted.</div></div><div><h3>Results</h3><div>Twelve pancreatic juice cytology samples were aspirated every 2 to 3 hours over 3 days, each exceeding 1 mL. One sample (10th) was classified as Class IV, “suspicious for adenocarcinoma,” with cytology revealing nuclear enlargement and atypia. The patient was diagnosed preoperatively with pancreatic cancer (TisN0M0 stage 0) and underwent distal pancreatectomy without neoadjuvant chemotherapy. Pathology confirmed HG-PanIN of the MPD. The patient had no postoperative adverse events and remained recurrence-free at the 9-month follow-up.</div></div><div><h3>Conclusions</h3><div>This case highlights the effectiveness of balloon enteroscopy-assisted SPACE in diagnosing HG-PanIN in surgically altered anatomy. However, given the relatively high risk of pancreatitis, SPACE should be reserved for patients with imaging or clinical findings suggestive of malignancy. By overcoming technical obstacles, this method offers a promising diagnostic strategy for early-stage pancreatic ductal adenocarcinoma in surgically altered anatomy.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 6","pages":"Pages 302-306"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946647","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":"Transvaginal flexible endoscopy for bleeding arteriovenous malformation hemostasis near a vesico-rectovaginal fistula","authors":"Reona Tsukii MD ,&nbsp;Kazuya Inoki MD, MPH, PhD ,&nbsp;Kenichi Konda MD, PhD ,&nbsp;Atsushi Katagiri MD, PhD ,&nbsp;Fuyuhiko Yamamura MD, PhD ,&nbsp;Takashi Mimura MD, PhD ,&nbsp;Hitoshi Yoshida MD, PhD","doi":"10.1016/j.vgie.2025.02.004","DOIUrl":"10.1016/j.vgie.2025.02.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Flexible GI endoscopy has been applied in the field of gynecology. GI endoscopy is useful in diagnosing uterine cervical cancers, because high-resolution imaging using magnification enables targeted biopsies. Moreover, hemostasis for uterine cancer using GI endoscopy and hemostatic forceps, as well as the local treatment of vaginal intraepithelial neoplasia, have been achieved.</div></div><div><h3>Methods</h3><div>In the present case, hemostasis for arteriovenous malformation using argon plasma coagulation was attained with transvaginal endoscopy.</div></div><div><h3>Results</h3><div>An 85-year-old female patient presented to our hospital for admission with intermittent rectal and genital bleeding. She had previously undergone concurrent chemoradiotherapy for cancer of the uterine body, at 45 years of age. Furthermore, she had undergone a colostomy and urostomy for a vesico-rectovaginal fistula, in her 70s. The source of the bleeding could not be identified by contrast-enhanced abdominal computed tomography, cystoscopy, vaginal examination, or rectal endoscopy. Spontaneous hemostasis was achieved; nevertheless, she was readmitted to our hospital because of a recurrence of symptoms and progressively worsening anemia. Vaginoscopy revealed blood in the vagina; however, the source of bleeding was not detected, particularly by subsequent rectal endoscopy. An oozing from arteriovenous malformation near the vesico-rectovaginal fistula was identified by transvaginal endoscopy. Hemostasis was achieved, using argon plasma coagulation. No recurrence of bleeding was observed after endoscopic hemostasis. The absence of symptomatic recurrence was confirmed at the 1-month follow-up, after discharge.</div></div><div><h3>Conclusions</h3><div>In this case, transvaginal endoscopy revealed the source of bleeding that was in the blind spot, during rectal endoscopy. This case highlighted that further applications using flexible GI endoscopy in the field of gynecology should be investigated.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 6","pages":"Pages 323-325"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946641","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":"Advanced endoscopic techniques for esophageal duplication cyst treatment: beyond surgery","authors":"Radhika Chavan MD, DNB ,&nbsp;Zaheer Nabi MD, DNB ,&nbsp;Sukrit Sud MD, DM ,&nbsp;Chaiti Gandhi MD, DNB ,&nbsp;Sanjay Rajput MD, DM ,&nbsp;D. Nageshwar Reddy MD, DM","doi":"10.1016/j.vgie.2025.02.002","DOIUrl":"10.1016/j.vgie.2025.02.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Esophageal duplication cysts are rare congenital anomalies characterized by an epithelial lining and muscular wall. Nowadays, esophageal duplication cysts are increasingly detected because of increased use of gastroscopy and cross-sectional imaging. Although surgery remains the standard treatment, endotherapy has emerged as a viable minimally invasive alternative, particularly for symptomatic patients or those unwilling or unfit for surgery. Endoscopic approaches include resection, fenestration, decompression, and submucosal tunneling endoscopic resection (STER).</div></div><div><h3>Methods</h3><div>This case series reviews 3 patients with symptomatic esophageal duplication cysts managed using advanced endoscopic techniques. Diagnosis was confirmed using gastroscopy and EUS. EUS demonstrated cystic lesions of submucosal origin with characteristic posterior acoustic enhancement. Endoscopic techniques included STER, and hybrid techniques combining EUS with endoscopic fenestration. All procedures were performed with the patient under sedation or general anesthesia, with postprocedure monitoring and follow-up at 1, 6, and 12 months.</div></div><div><h3>Results</h3><div>Three endoscopic techniques of esophageal duplication cysts are described with successful results. STER was performed in 1 patient for a small symptomatic midesophageal cyst. Hybrid technique combining EUS and endoscopic fenestration was performed in 2 patients by 2 techniques: (1) guidewire as guiding structure and (2) plastic stent as guiding structure. All 3 patients remained asymptomatic at a median follow-up of 12 months.</div></div><div><h3>Conclusions</h3><div>Advanced endotherapy, including hybrid techniques, offers an effective, minimally invasive alternative to surgery for managing esophageal duplication cysts. These procedures enable precise fenestration and reduce adverse events. Hybrid procedures can be considered for large cysts with exophytic components in patients at a high risk for surgery. Further studies with larger sample sizes and long-term follow-up are needed to validate these promising outcomes.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 6","pages":"Pages 326-332"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946637","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":"Double duty: using a PEG tube to address gastrogastric fistula and biliary drainage in a patient after Roux-en-Y","authors":"Preeyati Chopra MBBS,&nbsp;Ashwariya Ohri MBBS,&nbsp;Mayank Goyal MBBS,&nbsp;Navtej S. Buttar MD","doi":"10.1016/j.vgie.2025.02.007","DOIUrl":"10.1016/j.vgie.2025.02.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastrogastric fistula (GGF) is a known rare adverse event after gastric bypass surgery. Management of refractory GGF, either surgical or endoscopic, is associated with poor long-term results. There is limited evidence on the successful management of refractory GGF with endoscopy.</div></div><div><h3>Methods</h3><div>A 62-year-old female patient status post Roux-en-Y gastric bypass presented with symptoms of aspiration. She not was responsive to repeated endoscopic and laparoscopic methods for fistula closure, which made her unfit for surgical intervention. We decided to proceed with an endoscopic attempt for fistula management. On EGD, a 15-mm fistula between the gastric pouch and the remnant stomach was seen. A 24F PEG tube bumper with a 25-mm diameter was folded with a grasping device and inserted in the 15-mm fistula, such that the bumper fully covered the fistula. The bumper was sutured to the surrounding mucosa in a purse string fashion. The open tip of the PEG tube was driven into the Roux limb and sutured in the jejunum to prevent migration of the tube. This achieved the dual purpose of closing the site of the fistula with the PEG bumper while securing a draining tube to prevent aspiration of the bile reflux in the gastric pouch.</div></div><div><h3>Results</h3><div>A postprocedure fluoroscopy demonstrated no evidence of a fistula. At follow-up, the patient reported no reflux and complete resolution of symptoms. The patient is planned for a yearly replacement of the PEG tube, given multiple comorbidities and a hostile abdomen due to previous procedures that make her unfit for surgical intervention.</div></div><div><h3>Conclusions</h3><div>In a patient who did not respond to repeated endoscopic and laparoscopic methods for management, we describe a novel endoscopic technique for management of refractory GGF using a PEG tube serving the dual purpose of plug and drain after Roux-en-Y gastric bypass surgery.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 7","pages":"Pages 355-357"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364694","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":"Transparent cap scope tamponade: an inexpensive, efficient, and underappreciated maneuver for bleeding visualization and hemostasis","authors":"Brandon Rodgers MD ,&nbsp;Swapnil Patel DO ,&nbsp;Matthew T. Moyer MD, MS, FASGE","doi":"10.1016/j.vgie.2025.02.001","DOIUrl":"10.1016/j.vgie.2025.02.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Low-grade bleeding is commonly encountered during endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), and there are several hemostasis techniques that can be used, each with advantages and disadvantages. One efficient, inexpensive, and underappreciated technique is the use of a distal attachment on the endoscope to provide immediate scope tamponade that quickly stops most low-grade bleeding.</div></div><div><h3>Methods</h3><div>The use of the distal attachment during endoscopic resection improves scope stability, and when low- to moderate-grade bleeding occurs, it can be used in conjunction with water infusion to quickly allow visualization of the source of the bleed. Subsequently, the tip of the distal attachment can be easily applied to the source of the bleeding, allowing immediate control or allowing time to retrieve a more definitive hemostatic device.</div></div><div><h3>Results</h3><div>Four cases are presented demonstrating the valuable uses of the transparent distal cap attachment during EMR of a variety of colonic lesions.</div></div><div><h3>Conclusions</h3><div>Using the distal attachment cap to provide scope tamponade is an effective, inexpensive, and underappreciated strategy to achieve hemostasis in low- to moderate-grade intraprocedural bleeding.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 6","pages":"Pages 333-335"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946638","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":"Feasibility of performing cryoballoon ablation for treatment of residual ampullary neoplastic lesions using a duodenoscope","authors":"Tammy Tran MD, MBA,&nbsp;Anand Kumar MD, MPH, FASGE","doi":"10.1016/j.vgie.2025.01.012","DOIUrl":"10.1016/j.vgie.2025.01.012","url":null,"abstract":"","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 6","pages":"Pages 319-322"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946640","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}