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6th Annual Long Island Live Endoscopy Course
February 28, 2014
Garden City Hotel
2014 Course Overview
Endoscopic resection techniques are in a state of rapid evolution. Per Oral Endoscopic Myotomy (POEM), although conceived as a NOTES approach for the treatment of achalasia, a rare benign esophageal disorder, is revolutionizing endoscopic resection in the United States and around the world. Endoscopic Submucosa Dissection (ESD), a technique developed in Asia for en bloc resection of early mucosal cancers forms the basis of POEM. Interestingly, in the past 4 years, POEM has done more to accelerate adoption of ESD in the West than fifteen years worth of favorable ESD data from Asia. Furthermore, the parent technique of POEM, Submucosal endoscopy, has allowed endoscopists to safely access the peritoneum and mediastinum, previously the exclusive realm of the surgeon. Routine access of these previously taboo spaces during POEM, has encouraged endoscopists to venture through the wall of the GI tract more frequently and with more alacrity that envisioned even in the heyday of NOTES enthusiasm. An example of such offshoots of POEM, is the use of STER (Submucosal Tunneling Endoscopic Resection) for en-bloc resection of tumors involving and even breeching the wall of the GI tract. A guiding principle for Long Island Live has always been the exploration of new frontiers of endoscopy and exposure of participants to novel and disruptive technologies and techniques that may shape the future of endoscopy.
The 2014 course consisted of live cases and lectures and brought together again a great team of masters as faculty: Christopher Gostout, whose team invented the Submucosal Endoscopy technique; Haru Inoue from Yokohama, Japan, one of the fathers of EMR and ESD and performer of the first human POEM; and Pinghong Zhou from Shanghai, an ESD master and inventor of STER with the largest POEM volume in the world currently at over 1000 procedures. These endoscopic resection visionaries reviewed and demonstrated these ground-breaking techniques once again. Christopher Gostout, will again serve as chief moderator. We had an "encore" performance of last year's very successful “POEM simultané” with Inoue, Zhou and Stavropoulos performing three POEMs simultaneously demonstrating current POEM technique variations with commentary by the inventor of SM endoscopy, Christopher Gostout. We then escalated to live demonstrations of ESD, EFTR and STER. In this year's course, the central theme was again the rapidly growing procedures that we perceive as "short-range NOTES" as they involve full thickness operations on the wall of the GI tract rather than operations at distant organs (such as the gallbladder or appendix) as envisioned in traditional NOTES that have failed to gain wide adoption. Staying on this theme of "short-range NOTES" we also presented a NOTES "sleeve gastroplasty" a procedure being studied at Winthrop along with a handful of other US centers including pioneers at the Mayo Clinic (Christopher Gostout) and Brigham & Women's (Christopher Thompson). Christopher Thompson demonstrated live a "sleeve gastroplasty," a procedure which has already generated tremendous interest among gastroenterologists and surgical endoscopists.