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Endoscopic Management of Complications: Perforations, Fistulas, and Bleeding

Behind The Knife: The Surgery PodcastJanuary 19, 20266 min276 views
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Managing Perforations After EMR

  • πŸ’‘ Perforation following Endoscopic Mucosal Resection (EMR) in the duodenum was managed using the OverStitch device for endoscopic suturing.
  • 🎯 The process involved taking full-thickness bites with the OverStitch device to ensure complete closure of the defect.
  • πŸ“Œ In the proximal stomach, a pinpoint perforation after EMR was successfully closed using an over-the-scope clip (OTSC) due to the defect's size.

Gastric Fistula Closure

  • πŸš€ A persistent gastriccutaneous fistula following PEG placement was addressed using an over-the-scope clip.
  • πŸ”¬ Argon plasma coagulation was employed around the fistula track to promote mucosal apposition before clip placement.

Management of Bleeding Post-Resection

  • ⚠️ The video covers the management of bleeding that occurs after the endoscopic resection of a polyp near the gastroesophageal junction.
  • ⚑ A hot snare was used to resect a raised lesion, and subsequent bleeding was addressed.

Endoscopic Tools and Techniques

  • πŸ› οΈ This series highlights the application of various endoscopic tools, including endoscopic suturing, over-the-scope clips, and argon plasma coagulation.
  • βœ… Becoming proficient with these endoscopic interventions can enable surgeons to manage complex patients nonoperatively.
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15 entities
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Transcript23 segments

Full Transcript

Topics11 themes

What’s Discussed

Endoscopic Mucosal Resection (EMR)Endoscopic SuturingOverStitch DeviceOver-the-Scope Clip (OTSC)Perforation ManagementGastric FistulaArgon Plasma CoagulationEndoscopic Bleeding ManagementPolyp ResectionGastroenterologySurgical Endoscopy
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