I am limbering up for a dose of endoscopy at UEG Week. The ESGE has already sent me free complimentary access to their eLearning unit "Colonoscopy – the Basics". Clearly they are trying to tell me something.
Hopefully you have now downloaded the UEG Week 2014 App, which allows you to choose between 20 different pathways. The UEG Week Vienna Pathways Tool can also be downloaded. I am particularly looking forward to the endoscopy pathway. On Saturday during the postgraduate teaching programme there will be two live endoscopy sessions in the afternoon. The live endoscopists can then relax until Tuesday morning when there will be wall-to-wall live endoscopy in Hall A.
These Live sessions do not always go to plan and they are a great opportunity to see experts get into and out of difficulties. Alex Meining is in charge and has told me that he has a record 36 cases lined up. He promises "polyps, polyps, polyps (small ones, ugly ones, polyps in the ileum, polyps in the rectum, polyps in Barrett's, polyps in the stomach), several IBD patients with strictures, new endoscopes (a new gastroscope and the three-lens screening colonoscope from FUSE, Olympus brand new extra-wide-angle scope, etc.). (Only) one ESD, a POEM, pancreatic cysts (with drainage, inspection of IPMN with Spy and confocal). In addition, there are pancreatic and biliary strictures of various types, contrast-enhanced EUS and various EUS-FNAs using various needles". Sounds like the kind of real-life stuff that is always interesting to see how other approach.
On Monday, I'm looking forward to the acute upper GI bleeding therapy update in Hall D. I've got high hopes for the Hemospray device, which I hope will allow me to stay in bed when injection and thermal therapy has failed. In my mind the only outstanding question is "Do we need to organise an early re-check the next morning?" My guess is yes, that white powder will not stay on forever!
We have two free paper sessions on new imaging and diagnostic modalities in upper and lower GI endoscopy on Monday afternoon. Not sure why the organisers haven't put the two sessions in the same hall though? Nevertheless, it's great to see that technology arms race is still in place. Sadly, there is a clash between the upper GI update and the update on gastro and duodenal endotherapy. I have the greatest respect for duodenal endotherapy, which is Tiger country indeed. It would be great if there were something that reduces the risk of late bleeding! For a large mucosal defect I spray thrombin, but this stuff is ridiculously expensive.
On Tuesday morning Lars Aabakken and I will be hosting a session dedicated to the future of colorectal cancer screening. We'll give you an update on what to do with sessile serrated lesions, and presentations on the thorny issue of how to prevent and deal with local recurrences. Hopefully we can get a consensus on how many times we should try to get rid of a local recurrence before we give up.
These are just some of the endoscopic happenings at UEG Week 2014. There are lots more to choose from including updates on Barrett's, EUS, ERCP, capsule and small bowel disease. Endoscopy continues to develop in numerous simultaneous directions driven by new technologies. I think that it has overtaken radiology in complexity, variety and colour!
Please give us some feedback on which endoscopy sessions you're enjoying throughout the meeting. The easiest way may be to tweet using any of the hashtags: #UEGWeek #endoscopy #UEGEducation. Alternatively, just grab me for a chat!