Clinical Endoscopy

Original Article

Efficacy and safety of intragastric balloon for obesity in Korea: Kwang Gyun Lee, Seung-Joo Nam, Hyuk Soon Choi, Hang Lak Lee, Jai Hoon Yoon, Chan Hyuk Park, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Sung Hoon Jung, Korean Research Group for Endoscopic Management of Metabolic Disorder and Obesity; Clin Endosc 2023;56(3):333-339. Published online December 13, 2022; DOI: https://doi.org/10.5946/ce.2022.143

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Background
/Aims: Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea.
Methods
We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed.
Results
In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m2. Body mass index reduction was 3.72±2.63 kg/m2 at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain.
Conclusions
IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.

Citations

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Intragastric Balloons
D.T.H. de Moura, Sergio A. Sánchez-Luna, Adriana Fernandes Silva, Alexandre Moraes Bestetti
Gastrointestinal Endoscopy Clinics of North America.2024;[Epub] CrossRef
How effective is intragastric balloon insertion as an obesity treatment in Korea?
Youngdae Kim
Clinical Endoscopy.2023; 56(3): 310. CrossRef
Laparoscopy-assisted trans-hiatal endoscopic removal of an intragastric balloon after placement-related esophageal perforation
Pablo Cortegoso Valdivia, Giorgio Dalmonte, Marina Valente, Lucia Ballabeni, Federica Gaiani, Gian Luigi de' Angelis, Federico Marchesi
Endoscopy.2023; 55(S 01): E1137. CrossRef

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Focused Review Series: Updates on endoscopic bariatric and metabolic therapies

Currently Available Non-Balloon Devices: Hang Lak Lee; Clin Endosc 2018;51(5):416-419. Published online September 27, 2018; DOI: https://doi.org/10.5946/ce.2018.143

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Obesity and metabolic syndrome are known to have an impact on the economy. Obesity and metabolic syndrome affect about 40% population in the America alone, and with about 400 million obese adults in the world, obesity is a global concern. Moreover, the prevalence of overweight children is increasing. Bariatric surgery remains the gold standard for the treatment of obesity; however, endoscopic approaches may have a significant role in the management of metabolic syndrome and obesity. Until recently, many endoscopic methods have been introduced; however, few methods are used in practice, whereas others are under experimental research. Endoscopists have an important role in the treatment of obesity because endoscopic therapies have demonstrated their safety and efficacy over the past few years. Endoscopic bariatric therapies can be categorized as follows: space occupying, malabsorption, and gastric volume reduction. In this review, we summarize the currently available non-balloon type endoscopic procedure.

Citations

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Endobariatric procedures for obesity: clinical indications and available options
Hemant Goyal, Jonathan Kopel, Abhilash Perisetti, Rupinder Mann, Aman Ali, Benjamin Tharian, Shreyas Saligram, Sumant Inamdar
Therapeutic Advances in Gastrointestinal Endoscopy.2021; 14: 263177452098462. CrossRef
The Effect of Endoscopic Bariatric and Metabolic Therapies on Gastroesophageal Reflux Disease
Su-Young Kim
Medicina.2021; 57(8): 737. CrossRef
Novel and emerging devices and operations in the treatment of obesity in children and adolescents
Hae Sung Kang, Jonathan DeAntonio, Claudio Oiticica, David Lanning, Allen Browne
Seminars in Pediatric Surgery.2020; 29(1): 150881. CrossRef

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Commentary

Identification of Ulceration in Early Gastric Cancer before Resection is Not Easy: Need for a New Guideline for Endoscopic Submucosal Dissection Indication Based on Endoscopic Image: Hang Lak Lee; Clin Endosc 2017;50(5):410-411. Published online September 29, 2017; DOI: https://doi.org/10.5946/ce.2017.140

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Citations

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Identification of maximal tumor size associated with negligible lymph node metastasis for endoscopic submucosal dissection of undifferentiated-type early gastric cancer
Sung Eun Oh, Soomin Ahn, Kyoung-Mee Kim, Min-Gew Choi, Jun Ho Lee, Tae Sung Sohn, Jae Moon Bae, Ji Yeong An
Gastric Cancer.2024;[Epub] CrossRef
Predictive factors of lymphatic metastasis and evaluation of the Japanese treatment guidelines for endoscopic resection of early gastric cancer in a high-volume center in Perú
Oscar Paredes, Carlos Baca, Renier Cruz, Kori Paredes, Carlos Luque-Vasquez, Iván Chavez, Luis Taxa, Eloy Ruiz, Francisco Berrospi, Eduardo Payet
Heliyon.2023; 9(5): e16293. CrossRef

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Original Article

Efficacy of the Over-the-Scope Clip System for Treatment of Gastrointestinal Fistulas, Leaks, and Perforations: A Korean Multi-Center Study: Hang Lak Lee, Joo Young Cho, Jun-Hyung Cho, Jong Jae Park, Chan Gyoo Kim, Seong Hwan Kim, Joung-Ho Han; Clin Endosc 2018;51(1):61-65. Published online August 29, 2017; DOI: https://doi.org/10.5946/ce.2017.027

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Background
/Aims: Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used for gastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate of endoscopic treatment using the OTSC system in Korea.
Methods
This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure.
Results
A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforations due to Boerhaave’s syndrome. Among these, there were three gastrojejunostomy sites, three esophagojejunostomy sites, four esophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures, one Boerhaave’s syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of the leakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure of the leak was achieved in 14 of 19 patients using OTSC alone.
Conclusions
The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases of anastomotic leakage after surgery.

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Petros Stathopoulos, Malte Zumblick, Sabine Wächter, Leif Schiffmann, Thomas M. Gress, Detlef Bartsch, Guido Seitz, Ulrike W. Denzer
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Hasnain S. Bawaadam, Matthew Russell, Yaron B. Gesthalter
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Exclusión pilórica con dispositivo Ovesco (over-thescope) en caso de fístula yeyunal en obstrucción duodenal de etiología maligna
Raul Eduardo Pinilla Morales, Helena Facundo Navia, Elio Fabio Sánchez Cortés, Ivette C. Jiménez Lafourie, Álvaro Eduardo Sánchez Hernández, Luis Carlos Llorente Portillo
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Chih Y. Tan, Htet A. Kyaw, Neda Farhangmehr, Cheuk‐Bong Tang, Naga V. Jayanthi
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Stephanie G. Jordan, Gregory J. Nolan
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A.V. Vodyasov, D.M. Kopaliani, P.A. Yartsev, O.Kh. Kaloeva
Khirurgiya. Zhurnal im. N.I. Pirogova.2021; (4): 78. CrossRef
An Approach to Accelerate Healing and Shorten the Hospital Stay of Patients With Anastomotic Leakage After Esophagectomy: An Explorative Study of Systematic Endoscopic Intervention
LeQi Zhong, JiuDi Zhong, ZiHui Tan, YiTong Wei, XiaoDong Su, ZheSheng Wen, TieHua Rong, Yi Hu, KongJia Luo
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Jeffrey H. Lee, Prashant Kedia, Stavros N. Stavropoulos, David Carr-Locke
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Diagnostic challenge and surgical management of Boerhaave’s syndrome: a case series
Jiayue Wang, Degang Wang, Jianjiao Chen
Journal of Medical Case Reports.2021;[Epub] CrossRef
Over-the-scope clip management of non-acute, full-thickness gastrointestinal defects
David J. Morrell, Joshua S. Winder, Ansh Johri, Salvatore Docimo, Ryan M. Juza, Samantha R. Witte, Vamsi V. Alli, Eric M. Pauli
Surgical Endoscopy.2020; 34(6): 2690. CrossRef
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Panida Piyachaturawat, Parit Mekaroonkamol, Rungsun Rerknimitr
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Therapie der Ösophagusleckagen
Jutta Weber-Eibel
Journal für Gastroenterologische und Hepatologische Erkrankungen.2020; 18(1): 8. CrossRef
Successful Closure of a Benign Refractory Tracheoesophageal Fistula Using an Over-the-Scope Clip after Failed Esophageal Stent Placement and Surgical Management
Nonthalee Pausawasdi, Chotirot Angkurawaranon, Tanyaporn Chantarojanasiri, Arunchai Chang, Wanchai Wongkornrat, Somchai Leelakusolvong, Asada Methasate
Clinical Endoscopy.2020; 53(3): 361. CrossRef
Clinical efficacy of the over-the-scope clip device: A systematic review
Nicholas Bartell, Krystle Bittner, Vivek Kaul, Truptesh H Kothari, Shivangi Kothari
World Journal of Gastroenterology.2020; 26(24): 3495. CrossRef
Endoscopic devices and techniques for the management of bariatric surgical adverse events (with videos)
Allison R. Schulman, Rabindra R. Watson, Barham K. Abu Dayyeh, Manoop S. Bhutani, Vinay Chandrasekhara, Pichamol Jirapinyo, Kumar Krishnan, Nikhil A. Kumta, Joshua Melson, Rahul Pannala, Mansour A. Parsi, Guru Trikudanathan, Arvind J. Trindade, John T. Ma
Gastrointestinal Endoscopy.2020; 92(3): 492. CrossRef
Gastrointestinal tract injuries after thermal ablative therapies for hepatocellular carcinoma: A case report and review of the literature
Teresa Marzia Rogger, Andrea Michielan, Sandro Sferrazza, Cecilia Pravadelli, Luisa Moser, Flora Agugiaro, Giovanni Vettori, Sonia Seligmann, Elettra Merola, Marcello Maida, Francesco Antonio Ciarleglio, Alberto Brolese, Giovanni de Pretis
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Over‐the‐scope clip system: A review of 1517 cases over 9 years
Hideki Kobara, Hirohito Mori, Noriko Nishiyama, Shintaro Fujihara, Keiichi Okano, Yasuyuki Suzuki, Tsutomu Masaki
Journal of Gastroenterology and Hepatology.2019; 34(1): 22. CrossRef
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Shirin Siddiqi, Dean P. Schraufnagel, Hafiz Umair Siddiqui, Michael J. Javorski, Adam Mace, Abdulrhman S. Elnaggar, Haytham Elgharably, Patrick R. Vargo, Robert Steffen, Saad M. Hasan, Siva Raja
Expert Review of Medical Devices.2019; 16(3): 197. CrossRef
Diagnosis and endoscopic treatment of esophageal leakage: a systematic review
Bram D. Vermeulen, Peter D. Siersema
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Management of esophagojejunal anastomosis leakage after total gastrectomy
Pablo Priego, Pietro Giordano, Marta Cuadrado, Araceli Ballestero, Julio Galindo, Eduardo Lobo
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Jeffrey R. Watkins, Alexander S. Farivar
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Focused Review Series: Roles of Bariatric Endoscopy in Obesity Treatment

Role of Restrictive Endoscopic Procedures in Obesity Treatment: Hang Lak Lee; Clin Endosc 2017;50(1):17-20. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.022

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It is well recognized that obesity is a big problem and it can induce large economic burden. Obesity affects about 40% people in the America alone and obesity also is the worldwide problem, with about 400 million obese adults. Moreover, another problem of obesity is the increasing prevalence of overweight children. Though bariatric surgery remains the gold treatment modality in the obesity treatment, endoluminal approaches may have the meaningful role for weight control. Endoscopists should have a role in the management of obesity because endoluminal therapies demonstrate their safety and efficacy over the coming years. Endoluminal therapies can be summarized by above methods: space occupying, malabsorption method, and reduction of gastric volume. In this review, we will introduce various restrictive endoscopic procedures in obesity treatment.

Citations

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Endoscopic Bariatric Therapy for Obesity and Metabolic Syndrome
Sang Pyo Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(4): 247. CrossRef
Endobariatric procedures for obesity: clinical indications and available options
Hemant Goyal, Jonathan Kopel, Abhilash Perisetti, Rupinder Mann, Aman Ali, Benjamin Tharian, Shreyas Saligram, Sumant Inamdar
Therapeutic Advances in Gastrointestinal Endoscopy.2021; 14: 263177452098462. CrossRef
Novelties in the treatment of obesity
Pavol Holéczy
Medicína pro praxi.2019; 16(4): 259. CrossRef
Currently Available Non-Balloon Devices
Hang Lak Lee
Clinical Endoscopy.2018; 51(5): 416. CrossRef

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Focused Review Series: Advances in the management of upper GI SET

Advances in the Management of Upper Gastrointestinal Subepithelial Tumor: Pathologic Diagnosis Using Endoscopy without Endoscopic Ultrasound-Guided Biopsy: Hang Lak Lee; Clin Endosc 2016;49(3):216-219. Published online May 30, 2016; DOI: https://doi.org/10.5946/ce.2016.064

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Until now, biopsy methods for subepithelial tumors (SETs) have focused on endoscopic ultrasound (EUS)-guided biopsy; however, these methods have several limitations. We devised a simple method for pathologic diagnosis of SETs. SETs are occasionally diagnosed during endoscopy, and lesions are generally small and asymptomatic. It can be challenging to decide on a management plan for large asymptomatic SETs. EUS imaging provides information regarding the size, layer, and echo pattern of the lesions. Patient management plans have traditionally been determined based on EUS images, whereby the endoscopist chooses to either monitor or remove the tumor. However, EUS alone cannot diagnose and evaluate upper gastrointestinal SETs with high accuracy. As sufficient tissue samples are required for the accurate diagnosis of SETs, EUS-guided biopsy techniques such as EUS fine-needle aspiration and trucut biopsy are currently used. However, these methods have a relatively low diagnostic accuracy and do not always provide information upon immunohistochemical staining. Endoscopists can easily detect a submucosal mass after creating an iatrogenic mucosal ulcer, after which tissue sampling is performed by using endoscopic biopsy. Furthermore, pathologic results can differentiate between benign and premalignant lesions. Here, we introduce a simple method for the pathologic diagnosis of SETs.

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Yuzhu Yuan, Lixin Sun, Xiaoying Zhou, Han Chen, Xinmin Si, Weifeng Zhang, Yun Wang, Bixing Ye, Nana Tang, Guoxin Zhang, Xueliang Li, Hongjie Zhang, Chunhua Jiao
Gastric Cancer.2022; 25(5): 929. CrossRef
Controversies in EUS: Do we need miniprobes?
Hans Seifert, Pietro Fusaroli, PaoloGiorgio Arcidiacono, Barbara Braden, Felix Herth, Michael Hocke, Alberto Larghi, Bertrand Napoleon, Mihai Rimbas, BogdanSilvio Ungureanu, Adrian Sãftoiu, AnandV Sahai, ChristophF Dietrich
Endoscopic Ultrasound.2021; 10(4): 246. CrossRef
Overcoming the Challenge of Full-Thickness Resection of Gastric Lesions Using a Colonic Full-Thickness Resection Device
Yazan Fahmawi, Patel Krutika, Manoj Kumar, Lindsey Merritt, Meir Mizrahi
ACG Case Reports Journal.2020; 7(3): e00329. CrossRef
Digital image analysis-based scoring system for endoscopic ultrasonography is useful in predicting gastrointestinal stromal tumors
Moon Won Lee, Gwang Ha Kim, Kwang Baek Kim, Yoon Ho Kim, Do Youn Park, Chang In Choi, Dae Hwan Kim, Tae Yong Jeon
Gastric Cancer.2019; 22(5): 980. CrossRef
Endoscopic full‐thickness resection for gastrointestinal submucosal tumors
Ming‐Yan Cai, Francisco Martin Carreras‐Presas, Ping‐Hong Zhou
Digestive Endoscopy.2018; 30(S1): 17. CrossRef

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Original Article

Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea: Yu Kyung Cho, Jeong Seop Moon, Dong Su Han, Yong Chan Lee, Yeol Kim, Bo Young Park, Il-Kwun Chung, Jin-Oh Kim, Jong Pil Im, Jae Myung Cha, Hyun Gun Kim, Sang Kil Lee, Hang Lak Lee, Jae Young Jang, Eun Sun Kim, Yunho Jung, Chang Mo Moon, Ethics and Quality Control Committee of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2016;49(6):542-547. Published online March 2, 2016; DOI: https://doi.org/10.5946/ce.2015.113

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Background
/Aims: In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions.
Methods
We surveyed the staff of institutional endoscopic units via e-mail.
Results
Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program.
Conclusions
Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

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Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5‐year experience in an endoscopy center
Shu‐Hui Chen, Theophile Liu, Huei‐Wen Lai, Hui‐Lan Chang, Hsu‐Heng Yen
Advances in Digestive Medicine.2022; 9(2): 103. CrossRef
A nationwide survey on the effectiveness of training on endoscope reprocessing within the national cancer screening program in Korea
Hye Young Shin, Da Hun Jang, Jae Kwan Jun
American Journal of Infection Control.2021; 49(8): 1031. CrossRef
Polyp missing rate and its associated risk factors of referring hospitals for endoscopic resection of advanced colorectal neoplasia
Jae Gyu Shin, Hyung Wook Kim, Su Bum Park, Cheol Woong Choi, Dae Hwan Kang, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu
Medicine.2017; 96(19): e6742. CrossRef
Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy
Hee Seok Moon, Eun Kwang Choi, Ji Hyun Seo, Jeong Seop Moon, Ho June Song, Kyoung Oh Kim, Jong Jin Hyun, Sung Kwan Shin, Beom Jae Lee, Sang Heon Lee
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Yu Kyung Cho
Clinical Endoscopy.2016; 49(4): 312. CrossRef
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Dong-Hoon Yang
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In Kyung Yoo, Yoon Tae Jeen
Clinical Endoscopy.2016; 49(6): 495. CrossRef

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Case Report

Endoscopic Treatment of a Symptomatic Ileal Lipoma with Recurrent Ileocolic Intussusceptions by Using Cap-Assisted Colonoscopy: Eun Sung Lee, Kang Nyeong Lee, Kyung Soo Choi, Hang Lak Lee, Dae Won Jun, Oh Young Lee, Byung Chul Yoon, Ho Soon Choi; Clin Endosc 2013;46(4):414-417. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.414

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A 73-year-old woman presented with intermittent abdominal pain and weight loss of 15 kg for 2 years. Colonoscopy revealed an erythematous polypoid tumor with a long and wide stalk in the cecum, but with air inflation, it abruptly went away through the ileocecal valve (ICV). An abdominal computed tomography showed a well-demarcated pedunculated subepithelial mass of 2.6×2.7 cm size with fat attenuation in the terminal ileum. It was an intussusceptum of the ileal lipoma through the ICV. This ileal lipoma was causing her symptoms because repeated ileocolic intussusceptions resulted in intermittent intestinal obstructions. In order to avoid surgical sequelae of ileal resection, snare polypectomy using cap-assisted colonoscopy technique was performed within the ileum without complications. The histopathology report confirmed it as a subepithelial lipoma. After endoscopic resection of the ileal lipoma, the patient has been free of symptoms and was restored to the original weight.

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Extraction of terminal ileal lipomas to cecum can facilitate endoscopic resection: A case series with video
Hiroshi Yamazaki, Yohei Minato, Deepak Madhu, Toshifumi Iida, Susumu Banjyoya, Tomoya Kimura, Koichi Furuta, Shinya Nagae, Yohei Itou, Nao Takeuchi, Shunya Takayanagi, Yoshiaki Kimoto, Yuki Kano, Takashi Sakuno, Kohei Ono, Ken Ohata
DEN Open.2025;[Epub] CrossRef
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Terminal Ileum Lipoma Causing Ileocolic Intussusception: A Case Report and Literature Review
Siddhant Dogra, Jason Wei, Benjamin Wadowski, Virginia Devi-Chou, Leandra Krowsoski, Rajiv R Shah
Cureus.2023;[Epub] CrossRef
Successful endoscopic management of adult ileocecal intussusception secondary to a large ileal lipoma
Akira Teramoto, Seiji Hamada, Takahiro Utsumi, Daizen Hirata, Yasushi Sano
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Life‐threatening gastrointestinal bleeding from a giant ileal lipoma
Amy Donovan, Sandun Abeyasundara, Hajir Nabi
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Intususcepción íleo-cólica de lipoma ileal como causa de hemorragia digestiva baja
Eduardo Valdivielso Cortázar, María López Álvarez, Alberto Guerrero Montañes, Loreto Yañez González-Dopeso, Jesus Ángel Yañez López, Pedro Antonio Alonso Aguirre
Gastroenterología y Hepatología.2017; 40(7): 457. CrossRef
Ileocolic intussusception of ileal lipoma as a cause of lower gastrointestinal bleeding
Eduardo Valdivielso Cortázar, María López Álvarez, Alberto Guerrero Montañes, Loreto Yañez González-Dopeso, Jesus Ángel Yañez López, Pedro Antonio Alonso Aguirre
Gastroenterología y Hepatología (English Edition).2017; 40(7): 457. CrossRef
Unroofing Technique as an Option for the Endoscopic Treatment of Giant Gastrointestinal Lipomas
Marcela Kopáčová, Stanislav Rejchrt, Jan Bureš
Acta Medica (Hradec Kralove, Czech Republic).2015; 58(4): 115. CrossRef

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Original Article

International Live Endoscopic Multichannel Demonstration Using Superfast Broadband Internet Connections: Sang Pyo Lee, Hang Lak Lee, Joon Soo Hahm, Ho Soon Choi, Inwhee Joe, Shuji Shimizu; Clin Endosc 2012;45(1):73-77. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.73

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Background/Aims

Telemedicine is a convenient and efficient tool for remote education in various fields. The telemedicine system can also be used to educate doctors and medical students. The aim of our study was to establish the effectiveness of the telemedical system for use in a live endoscopic multichannel demonstration conference and to test the effectiveness and usefulness of a multicenter-based live endoscopic demonstration through live, interactive, high resolution video transmission using advanced networks and the digital video transport system (DVTS).

Methods

This study is a prospective multicenter pilot study. A live demonstration of an endoscopic submucosal dissection (ESD) and an endoscopic retrograde cholangiopancreatography (ERCP) using advanced network technology was performed.

Results

The DVTS successfully transmitted uncompressed, high-resolution, digital lectures with endoscopy video during a multichannel endoscopic live demonstration of ESD and ERCP over multiple advanced networks. The overall satisfaction rating when the endoscopic lecture demonstration was performed by combining DVTS was generally good.

Conclusions

We believe that a multicenter-based live endoscopic demonstration is a very effective conferencing method when using advanced networks and DVTS.

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Hon Chi Yip, Noriya Uedo, Louis Ho‐Shing Lau, Daizen Hirata, Yasushi Sano, Philip Wai‐yan Chiu
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Current Applications of Telemedicine in Gastroenterology
Brian M. Fung, Eric Markarian, Marina Serper, James H. Tabibian
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