Hydrocolonoscopy – Key Concepts
Hydrocolonoscopy: A Five-Minute Introduction When you start a colonoscopy, you have two choices: insufflate with air or CO2, or fill the lumen with water. Most endoscopists use insufflation by habit. Klaus Monkemüller uses water first on every case without contraindications. This Quick Tip shows why. Why Water Works Water removes stool and debris from the…...
Ileum Intubation: Tips and Tricks
Ileum Intubation: Tips and Tricks Terminal ileum intubation is the clearest confirmation that you reached the cecum, and it enables direct mucosal evaluation of the ileum itself. The ileocecal valve, depending on its clock-face position on the screen, demands a different entry approach. Matching your scope torque and wheel inputs to that position is the…...
Spatial Orientation During Colonoscopy
Spatial Orientation During Colonoscopy Imagine navigating the distal rectum to locate a mucosal lesion, fissure, or fistula. You identify a rectal polyp, but as you rotate the scope and retroflex, you realize you are disoriented. Where exactly is this lesion? Is it anterior, posterior, left lateral, or right lateral? Documenting the precise anatomical location of…...
Extreme Endoscopy: The Double-Scope Rescue for Esophageal Perforation
Extreme Endoscopy: The Double-Scope Rescue A patient arrives after esophageal stent placement gone wrong. The stent has migrated across the esophagogastric junction into the pleura. There is a large perforation, sepsis, open surgery, and now a complete anastomotic dehiscence. Upper endoscopy confirms the guidewire is entering the abdominal cavity. Standard wire placement is not possible…....
Train Your Eye to Detect Early Gastric Cancer
Train Your Eye to Detect Early Gastric Cancer You are performing a routine upper endoscopy and notice a subtle area of redness in the gastric body. There is no obvious mass. No dramatic ulcer crater. The mucosa looks slightly irregular, and the vascular pattern seems to thin out in one zone. Could this be early…...
ERCP Cannulation Tips: Curving the Catheter
You are performing an ERCP and the papilla sits inside a periampullary diverticulum, partially hidden and angled away from you. Your standard sphincterotome cannot engage the orifice. A tapered-tip catheter is the right tool, but even that comes out straight and misses the angle. What if you could shape the catheter to match the anatomy…...
Using a Distal Cap to Remove Meat Impaction
Using a Distal Cap to Remove Meat Impaction: A Three-Minute Trick Food bolus impaction is one of the most common endoscopic emergencies. The patient is anxious, secretions are pooling, and the standard rat-tooth grasper keeps fragmenting the bolus into pieces that won’t pass. There is a better tool already on your tray: and it’s the…...
Caps in GI Endoscopy
COURSE VIDEO Course: Barrett's Esophagus From Caps in GI Endoscopy: Part 2 Watch the full video with EndoCollab membership. Get the complete lecture, the rest of this course, and the full EndoCollab library of practical teaching resources. See membership options or log in if you already have access…. Membership Required You must be a member...
OTSC for Duodenal Ulcer Bleeding: A One-Stop Solution for Challenging Cases
When faced with active duodenal ulcer bleeding, particularly in anatomically challenging locations, the Over-The-Scope Clip (OTSC) can be your best friend. Today I want to share a case that perfectly demonstrates why this tool should be in every endoscopist’s arsenal for high-risk bleeding scenarios. The Clinical Challenge This patient presented with active bleeding from a…...
Managing Heyde Syndrome: From Aortic Valves to Endoscopic Intervention
Heyde syndrome represents one of the most fascinating intersections between cardiology and gastroenterology, where aortic stenosis leads to gastrointestinal bleeding through acquired von Willebrand disease. Understanding the full spectrum of management options is crucial for optimizing patient outcomes in this complex condition. The Expanding Spectrum of Heyde Syndrome What we’ve learned over the years…...
Mastering Argon Plasma Coagulation: Four Essential Techniques for Better Outcomes
Argon plasma coagulation (APC) ranks among the most frequently performed therapeutic interventions in gastrointestinal endoscopy. While APC serves multiple purposes beyond hemostasis, mastering the nuances of bleeding control: whether for prophylaxis or active treatment: remains fundamental to our practice. Today, I’ll share four refined techniques that can significantly improve your outcomes when treating angiodysplasias, GAVE,…...
Hemostatic Powders: A Modern Tool for Gastrointestinal Bleeding
Hemostatic powders represent one of the most interesting developments in endoscopic bleeding management over the past decade. While traditional mechanical and thermal methods remain our mainstays, these powder-based agents offer unique advantages in challenging bleeding scenarios where conventional approaches may fall short. The Science Behind Hemostatic Powders The mechanism of action for hemostatic powders is…...