This video installment from the Surgical Endoscopy Team at Behind the Knife presents four different scenarios where complications are managed endoscopically.
The four scenarios include: Perforation following Endoscopic Mucosal Resection (EMR) in the Duodenum: A duodenal polyp was resected using EMR. An obvious full-thickness defect was noted at the resection bed. This perforation was managed with endoscopic suturing using the OverStitch device. The patient was kept overnight for observation and discharged without a contrast study. Perforation following EMR in the Proximal Stomach: EMR was performed in the proximal stomach using a saline lift. A full-thickness perforation was seen following resection. Because the defect was pinpoint in nature, an over-the-scope clip was used instead of endoscopic suturing for closure. Gastric Fistula Closure: This scenario features the use of an over-the-scope clip to close a persistent gastocutaneous fistula following PEG placement. Argon plasma coagulation was used to ablate the area around the fistula track to aid with mucosal apposition before clip placement. Management of Bleeding: The final scenario addresses the management of bleeding following the endoscopic resection of a polyp near the gastroesophageal junction. The lesion was a raised lesion that was removed with a hot snare. Podcast: https://app.behindtheknife.org/podcast/surgical-endoscopy-series-ep-4-endoscopic-management-of-complications In their fourth episode, the BTK Surgical Endoscopy team delves into the endoscopic management of the dreaded and unexpected. They review how to take care of high-risk surgical complications and introduce the use of a number of endoscopic tools including suturing, stent placement, clips, and the EndoVac. Following a review of a variety of endoscopic techniques, they present case-based scenarios that allow the listeners to understand the application of the endoscopic interventions in everyday practice. Becoming facile with endoscopic interventions may give surgeons the ability to nonoperatively take care of the most complex patients. Hosts: • Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgeon, Dell Medical School, University of Texas at Austin (Austin, TX), @SAyusoMD (Twitter) • Dr. H. Mason Hedberg, Minimally Invasive Surgeon, Endeavor Health (Evanston, IL) • Dr. Trevor Crafts, Minimally Invasive Surgeon, Rocky Mountain VA Medical Center (Denver, CO), @CraftsTrevor (Twitter) • Dr. Zachary Callahan, Minimally Invasive Surgeon, Nashville Surgical Associates (Nashville, TN), @zmcallahan (Twitter) Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US