#ESD #ScopingSundays summary! #GITwitter ASGE GI Endoscopy ACG BIDMC_GI American Gastroenterological Association (AGA) #EndoLuminalSurgery #endoscopy #cancercare

Mohammad Bilal, MD Moamen Gabr Iman Boston, M.D., M.B.A. #ScopingSundays Erik Holzwanger, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Ahmed Saeed, MD Anand Kumar, MD MPH Sunil Amin, MD Uzma Siddiqui (she/her) Aziz Aadam Dennis Yang, MD, FACG,AGAF,FASGE Neil Sharma That’s an interesting point Mohammad Bilal, MD … roping in Kenneth Park, MD, MSc, DABOM who performs ESDs Cedars-Sinai Academic Medicine … thoughts?

Antonio Mendoza Ladd MD, AGAF, FACG, FASGE Erik Holzwanger, MD #ScopingSundays Iman Boston, M.D., M.B.A. Moamen Gabr Mohammad Bilal, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Sunil Amin, MD Amit Bhatt MD Dennis Yang, MD, FACG,AGAF,FASGE Tyler Berzin MD, FASGE Nadeem Tehami Dr John Leeds Steven Bollipo Keith Siau Katarzyna Monika Pawlak Mariajose Rojas Robert Bechara Abhishek Agnihotri, MD Barham Abu Dayyeh MD MPH FASGE FAGA Prasad G. Iyer, MD Eric J. Vargas M.D. M.S. ABOM Violeta Popov, MD PhD (she/her) Ravi Shah Shima Ghavimi Judy Trieu, MD, MPH Ahmad.Madkour Akwi Asombang MD MPH shaimaa elkholy Sherif Andrawes MD Mohamed Othman Salmaan Jawaid, MD That’s how many of us trained. It was helpful the first few years bc it forces fundamentals.

Erik Holzwanger, MD #ScopingSundays Iman Boston, M.D., M.B.A. Moamen Gabr Mohammad Bilal, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Amit Bhatt MD Neil Sharma Dennis Yang, MD, FACG,AGAF,FASGE Tyler Berzin MD, FASGE Nadeem Tehami Dr John Leeds Steven Bollipo Keith Siau Katarzyna Monika Pawlak Mariajose Rojas Robert Bechara Abhishek Agnihotri, MD Barham Abu Dayyeh MD MPH FASGE FAGA Prasad G. Iyer, MD Eric J. Vargas M.D. M.S. ABOM Violeta Popov, MD PhD (she/her) Ravi Shah Shima Ghavimi Judy Trieu, MD, MPH A little late to the party but in addition to all those wonderful devices you mention Erik Holzwanger, MD can’t forget simple rubber band traction! Quick, easy and most importantly cheap!

Sunil Amin, MD Erik Holzwanger, MD #ScopingSundays Iman Boston, M.D., M.B.A. Mohammad Bilal, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Amit Bhatt MD Neil Sharma Dennis Yang, MD, FACG,AGAF,FASGE Tyler Berzin MD, FASGE Nadeem Tehami Dr John Leeds Steven Bollipo Keith Siau Katarzyna Monika Pawlak Mariajose Rojas Robert Bechara Abhishek Agnihotri, MD Barham Abu Dayyeh MD MPH FASGE FAGA Prasad G. Iyer, MD Eric J. Vargas M.D. M.S. ABOM Violeta Popov, MD PhD (she/her) Ravi Shah Shima Ghavimi Judy Trieu, MD, MPH Great tool! When it comes to traction the simplest tools are the way to go. I personally try to keep complexity to the minimum. More efficient!

Great educational lecture form the #scopingsundays #MedEd initiative on ESD!

Relevant to below:
>270 degree resection with utilization of that device
See another post of mine for example of “traction in action” with the device.

#Endoscopy
#GITwitter
#Wireisback

Antonio Mendoza Ladd MD, AGAF, FACG, FASGE Erik Holzwanger, MD #ScopingSundays Iman Boston, M.D., M.B.A. Moamen Gabr Mohammad Bilal, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Sunil Amin, MD Amit Bhatt MD Neil Sharma Dennis Yang, MD, FACG,AGAF,FASGE Tyler Berzin MD, FASGE Nadeem Tehami Dr John Leeds Steven Bollipo Keith Siau Katarzyna Monika Pawlak Mariajose Rojas Robert Bechara Abhishek Agnihotri, MD Barham Abu Dayyeh MD MPH FASGE FAGA Prasad G. Iyer, MD Eric J. Vargas M.D. M.S. ABOM Violeta Popov, MD PhD (she/her) Ravi Shah Shima Ghavimi Judy Trieu, MD, MPH Ahmad.Madkour Akwi Asombang MD MPH shaimaa elkholy Sherif Andrawes MD Mohamed Othman Salmaan Jawaid, MD I learned and practiced for 2 years without any traction then I started incorporating it. I have a firm believe Traction in endoscopic surgery provide safety and efficiency and opens the 🚪 to the future of this practice. Every surgeon needs the second hand (Traction)

Sunil Amin, MD Erik Holzwanger, MD #ScopingSundays Iman Boston, M.D., M.B.A. Moamen Gabr Mohammad Bilal, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Amit Bhatt MD Neil Sharma Dennis Yang, MD, FACG,AGAF,FASGE Tyler Berzin MD, FASGE Nadeem Tehami Dr John Leeds Steven Bollipo Keith Siau Katarzyna Monika Pawlak Mariajose Rojas Robert Bechara Abhishek Agnihotri, MD Barham Abu Dayyeh MD MPH FASGE FAGA Prasad G. Iyer, MD Eric J. Vargas M.D. M.S. ABOM Violeta Popov, MD PhD (she/her) Ravi Shah Shima Ghavimi Judy Trieu, MD, MPH Nicely demonstrated. Safe, easy, cheap and makes a difficult case more efficient. I love this technique for now. I do wish for something dynamic and independent from the scope or the knife. A second hand 🖐️

Mohammad Bilal, MD Iman Boston, M.D., M.B.A. #ScopingSundays Erik Holzwanger, MD Moamen Gabr Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Sunil Amin, MD Jeff Mosko Uzma Siddiqui (she/her) Dr. Amrita Sethi Louis Lau Dennis Yang, MD, FACG,AGAF,FASGE Agree with GA gravity modification is challenging. I’m using the water pressure method more often and it has worked well consistently.

Mohammad Bilal, MD Erik Holzwanger, MD #ScopingSundays Iman Boston, M.D., M.B.A. Moamen Gabr Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Ahmad.Madkour Violeta Popov, MD PhD (she/her) Akwi Asombang MD MPH shaimaa elkholy Dennis Yang, MD, FACG,AGAF,FASGE Sherif Andrawes MD Mohamed Othman Salmaan Jawaid, MD Douglas G. Adler MD, FASGE, FACG, AGAF Tyler Berzin MD, FASGE Douglas Pleskow Mandeep Sawhney Robert Bechara Judy Trieu, MD, MPH Yan Cui Eric Swei Ahmed Saeed, MD Saad Alrajhi-سعد محمد سعد الراجحي Shifa Umar, MD Sultan Mahmood MD Samir C. Grover MD Harry Thomas Dmitriy Kedrin MD,PhD Prasad G. Iyer, MD Saeed Ali, MD Tony S. Brar, MD Enrique de-Madaria Nick McDonald Neal Mehta Raj Shah Austin Chiang, MD MPH Daniela Guerrero Vinsard Matthew Fasullo Vinay Chandrasekhara, MD Olympus Neil Sharma I always use epi in my injection solution. 1 cc epi + 1 cc of methylene blue in 500 cc of Hetastarch

One of the underutilized features of an endoscope is 'Near focus'. Not only to examine a lesion for glandular pattern but to assist in ESD dissection itself. Helpful for submucosal vessels as they can be large vessels in colorectal ESD.
ASGE GI Endoscopy #ScopingSundays Eli Dickinson

Ahmad.Madkour salemyousef Erik Holzwanger, MD #ScopingSundays Iman Boston, M.D., M.B.A. Moamen Gabr Mohammad Bilal, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Violeta Popov, MD PhD (she/her) Akwi Asombang MD MPH shaimaa elkholy Dennis Yang, MD, FACG,AGAF,FASGE Mohamed Othman Salmaan Jawaid, MD Douglas G. Adler MD, FASGE, FACG, AGAF Tyler Berzin MD, FASGE Douglas Pleskow Mandeep Sawhney Robert Bechara Judy Trieu, MD, MPH Yan Cui Eric Swei Ahmed Saeed, MD Saad Alrajhi-سعد محمد سعد الراجحي Shifa Umar, MD Sultan Mahmood MD Samir C. Grover MD Harry Thomas Dmitriy Kedrin MD,PhD Prasad G. Iyer, MD Saeed Ali, MD Tony S. Brar, MD Enrique de-Madaria Nick McDonald Neal Mehta Raj Shah Austin Chiang, MD MPH Daniela Guerrero Vinsard Matthew Fasullo Vinay Chandrasekhara, MD After any large EMR- ESD dissection is complete I use 'near focus' or any similar scope feature to coagulate and ablate any submucosal vessels I see, can be very helpful !

Thank YOU to everyone for Rapid 🔥🔥🔥 session on “Basic & Advanced #ESD ”

We would like to THANK our moderators Erik Holzwanger, MD & Iman Boston, M.D., M.B.A. + our Expert Guest Moamen Gabr!

Please let your comments tricke & we will post #ScopingSummary mid week!

Iman Boston, M.D., M.B.A. #ScopingSundays Erik Holzwanger, MD Moamen Gabr Mohammad Bilal, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Ahmad.Madkour Violeta Popov, MD PhD (she/her) Akwi Asombang MD MPH shaimaa elkholy Dennis Yang, MD, FACG,AGAF,FASGE Sherif Andrawes MD Mohamed Othman Salmaan Jawaid, MD Douglas G. Adler MD, FASGE, FACG, AGAF Tyler Berzin MD, FASGE Douglas Pleskow Mandeep Sawhney Robert Bechara Judy Trieu, MD, MPH Yan Cui Eric Swei Ahmed Saeed, MD Shifa Umar, MD Sultan Mahmood MD Samir C. Grover MD Sumant Inamdar Nick McDonald Neal Mehta Roberto Trasolini James Stone Depends on size and site. I like to start clips with dragging. If that doesnt do it then full thickness suturing. I also think X-tacks work well for smaller defects

Keith Siau Iman Boston, M.D., M.B.A. #ScopingSundays Erik Holzwanger, MD Moamen Gabr Mohammad Bilal, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Mohamed Othman Dennis Yang, MD, FACG,AGAF,FASGE Sumant Inamdar Alex Schlachterman alhaddad Abhishek Agnihotri, MD Tony S. Brar, MD Benjamin Tharian Ahmed Saeed, MD Sunil Amin, MD Salmaan Jawaid, MD Ahmad.Madkour Neil Sharma Judy Trieu, MD, MPH TaraKeihanian MD. MPH. Neal Mehta Aziz Aadam Sri Komanduri Tyler Berzin MD, FASGE Boston Scientific Nick McDonald shaimaa elkholy Sherif Andrawes MD Creo Medical Neethi Dasu Adolfo Parra-Blanco I am not patient enough to wait the assistance adjust the angle of the knife😅

Ahmad.Madkour salemyousef Erik Holzwanger, MD #ScopingSundays Iman Boston, M.D., M.B.A. Mohammad Bilal, MD Ahmad N. Bazarbashi Roberto Simons-Linares, MD 🇺🇦 Sergio A. Sánchez-Luna, MD, ABOM-D (He/Him) Ramzi Mulki, MD Lizzie Aby, MD Rashmi Advani, MD, ABOM-D Nneka N. Ufere, MD MSCE Jacqueline N. Chu, MD Malorie Simons Violeta Popov, MD PhD (she/her) Akwi Asombang MD MPH shaimaa elkholy Dennis Yang, MD, FACG,AGAF,FASGE Sherif Andrawes MD Mohamed Othman Salmaan Jawaid, MD Douglas G. Adler MD, FASGE, FACG, AGAF Tyler Berzin MD, FASGE Douglas Pleskow Mandeep Sawhney Robert Bechara Judy Trieu, MD, MPH Yan Cui Eric Swei Ahmed Saeed, MD Saad Alrajhi-سعد محمد سعد الراجحي Shifa Umar, MD Sultan Mahmood MD Samir C. Grover MD Harry Thomas Dmitriy Kedrin MD,PhD Prasad G. Iyer, MD Saeed Ali, MD Tony S. Brar, MD Enrique de-Madaria Nick McDonald Neal Mehta Raj Shah Austin Chiang, MD MPH Daniela Guerrero Vinsard Matthew Fasullo Vinay Chandrasekhara, MD Most bleeds will stop without intervention but we scope all patients presenting with overt delayed bleeding. Endoscopic interventions will shorten their hospital stay and won’t risk missing a chance to control a bleed early before patient decompensates.