Wire-Guided Basket Extraction for Difficult Bile Duct Stones
Wire-guided basket extraction: a step-by-step guide to when freehand fails, how to load a standard basket over the wire, and how to finish with leverage when the stone will not come. You have a complex stone in a dilated, irregular bile duct after secondary cholangitis. A freehand basket may never reach the left intrahepatic system…....
Snare Tip Assisted ESD EMR
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Endoscopic Resection Using the Oblique Cap (Inoue Cap)
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Cap-Assisted ESD for Dysplastic Barrett’s Esophagus
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Meckel’s Diverticulum
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Yao VS Classification for Early Gastric Cancer
Yao VS classification: a step-by-step guide to scoring mucosal surface, subsurface vessels, and the demarcation line when you inspect the stomach for early gastric cancer. You are looking at a subtle gastric lesion. Detection is only half the job. If the report says “suspicious area” without a structured surface and vessel score, the next endoscopist…...
ERCP U-Wire: Flip the Tip When the Wire Keeps Escaping
You place a self-expanding metal stent for a malignant bile duct stricture. Months later the patient is still alive, the stent is occluded, and every straight wire you pass wants to exit through the uncovered mesh. That is when the U-wire, or flipped wire tip technique, belongs in your ERCP plan. Why the Straight Wire…...
When Cold Snare Is Not Enough for a 6 to 10 mm Colon Polyp
A 6 to 10 mm colon polyp can look routine until the shape, margin, and histology make the resection less forgiving. In this clip, Klaus reviews why a small lesion still needs an individualized plan. The goal is simple: remove the lesion safely, completely, and with margins that can stand up to pathology. Why Shape…...
Cold Snare Polypectomy: Why Forceps and Hot Biopsy Fail
Cold Snare Polypectomy: Why Forceps and Hot Biopsy Fail You find a 5 mm sessile polyp in the transverse colon. The patient is on active anticoagulation. You want to resect it quickly, so you reach for the biopsy forceps or hot biopsy. This choice increases the risk of leaving adenomatous tissue behind. The key to…...
Prevent Post-Polypectomy Bleeding Before You Cut
Two Techniques That Prevent Bleeding Before You Cut You are about to resect a large flat polyp in the right colon. The patient takes apixaban. The resection itself is straightforward, but what happens after you cut determines whether the patient comes back over the weekend with delayed bleeding. Two decisions made before the snare closes…...
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…....
Using a Distal Cap to Remove Meat Impaction
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