Optimized Training in the Use of Endoscopic Closure Devices - 16/11/19

Doi : 10.1016/j.giec.2019.08.008

Majidah Abdulfattah Bukhari, MD, FASGE, FRCPC, ABIM, MRCP (GI) ^a,^b, Mouen A. Khashab, MD ^a,^c,^⁎
^a Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
^b Division of Medicine and Gastroenterology and Hepatology, International Medical Center, Jeddah 23214, Saudi Arabia
^c Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, 1800 Orleans Street, Zayed Building, Suite 7125B, Baltimore, MD 21287, USA

^∗Corresponding author. Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, 1800 Orleans Street, Zayed Bldg, Suite 7125B, Baltimore, MD 21287.Division of Gastroenterology and HepatologyJohns Hopkins Hospital1800 Orleans StreetZayed BldgSuite 7125BBaltimoreMD21287

Résumé

Successful closure of gastrointestinal defects is one of the most important goals for therapeutic endoscopy. Historically, surgical repair was the mainstay of treatment for any gastrointestinal defect; however, surgery is associated with high morbidity and mortality. Endoscopic management of gastrointestinal defects has developed rapidly in recent years and has become more effective, reducing the morbidity and mortality rates, and avoiding surgical interventions. Appropriate use of endoscopic techniques requires extensive knowledge of the devices and their advantages and limitations during practical applications.

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Keywords : Endoscopic closure, Gastrointestinal perforation, Gastrointestinal Leak, Gastrointestinal fistula, Devices, Techniques, Endoscopic management, Advantages, Limitations

Plan

Key points

Introduction

The required skill set

Required Knowledge and Technical Skills to Be Mastered by the Trainee Before Learning Endoscopic Closure

Management of gastrointestinal defects

Endoscopic closure devices

Through the Scope Clips

Over the scope Clips

Endoscopic Suturing

Assist Devices

Postendoscopic closure care

Summary

Financial Disclosures and Conflicts of Interest: M. A. Khashab is a consultant and on medical advisory board for Boston Scientific and Olympus and a consultant for Medtronic.