ESD
False- ESD can be performed in the esophagus, stomach, small intestine, and large intestine
What is the endoscopic alternative to a sleeve gastrectomy?
False: For defects that are too big for X-Tack, Overstitch is a viable alternative
This maneuver must be done prior to passing a scope with Overstitch
Jaw thrust
True or False: If the 2T goes down, suturing cases cannot be performed at VHC
False: NXT is used on a standard EGD scope
Contrary to piecemeal EMR, when performing ESD our goal is to remove the lesion ________ (2 words)
En Bloc
When a patient regains weight after Roux-En-Y Gastric Bypass, what is the recommended endoscopic treatment?
TORE (Transoral Outlet Reduction)
How closely should each tack be placed to the defect to ensure proper bite?
5-10mm
What device is used to help physicians grab difficult to reach tissue and bring closer to the scope?
Tissue Helix
When fixating an Esophageal Stent or Axios, the physicians will sometimes make this slight change to X-Tack to lessen the time it takes
Remove the suture
What is the most common polyp classification used by physicians?
Paris Classification
~70%
What mechanism prevents tacks from falling onto the ground if they become dislodged from the catheter before being passed down the scope?
Knot on end of suture
Name the 3 most common procedures where Overstitch is used
Defect Closure
Endobariatrics (ESG, TORE, Revision)
Stent Fixation
When would Overstitch be needed to do an ERCP?
EDGE (Endoscopic Ultrasound-Directed Transgastric ERCP)
Outside of ESD, what is another type of third space procedure?
POEM
What are the 2 most common side effect patients experience after ESG?
Pain & Nausea
The _______ prevents the tack from going too deep into tissue.
eyelet
Why can't Overstitch be used in the right side of the colon?
It can only be used on an EGD scope and cannot reach
This tissue resection procedure is done on the 3rd Tuesday of the month in the OR by Dr Mehta & Fazel (Hint: EMR, ESD, _____)
EFTR (Endoscopic Full-Thickness Resection)
Name the 4 layers of the GI tract
Mucosa
Submucosa
Muscularis Propia
Serosa
Which suture pattern is most commonly used to reduce the size of the outlet during TORE?
Circumferential (Purse string)
Name 2 out of 4 of the criteria that determine the quality of a bite
Forward pressure on catheter
Number of turns
Insufflation
Angulation
What kind of suture is used with Overstitch?
2-0 Polypropylene
What goes into the lifting agent for ESD/EMRs?
500ml Hespan & 1cc Methylene blue