Current Issue: October 2021
Image Gallery
Our choice of this month's most significant images.
Polysaccharide hemostatic powder to prevent bleeding after endoscopic submucosal dissection in high risk patients: a randomized controlled trial
Fig. 1 Endoscopic views showing: a a slightly depressed early gastric cancer at the antrum; b a post-resection ulcer (maximum diameter 58 mm) after completion of endoscopic submucosal dissection; c the appearance after application of polysaccharide hemostatic powder to the post-resection ulcer surface.
Transpancreatic biliary sphincterotomy versus double guidewire in difficult biliary cannulation: a randomized controlled trial
Fig. 2 Transpancreatic biliary sphincterotomy (TPBS) and additional needle-knife technique. a Schematic. b Endoscopic view. After TPBS, access into the common bile duct (CBD) may succeed either through the papilla, through the upper corner of the cut, or after oblique needle-knife cut across the CBD. PD, pancreatic duct; green line, line of sphincterotomy; red line, additional needle-knife cut.
Art in Endoscopy – “Moai Monolith Mysteries”
Fig. 1 Iatrogenic antral ulcer with an upright clot.
by Gertjan Rasschaert
“Art in endoscopy” is an initiative of four gastroenterologists in training that aims to display examples of the incidentally beautiful images that are sometimes encountered in regular endoscopic practice.
Hybrid endoscopic submucosal dissection (ESD) compared with conventional ESD for colorectal lesions: a systematic review and meta-analysis
Fig. 1 Hybrid endoscopic submucosal dissection (ESD). a The lesion is lifted using a needle injector. b Mucosal incision is performed using a needle type ESD knife. c Partial submucosal dissection is performed using a needle type ESD knife. d A snare is placed around the lesion after circumferential mucosal incision and partial submucosal dissection is performed. e The snare is closed to resect the lesion traversing the submucosal space. f The target lesion is completely removed. g Visible vessels at the defect site are coagulated using coagulation graspers.
Transoral outlet reduction: could additional sutures cause more harm?
Fig. 2 The double purse-string pattern (DPSP) procedure for transoral outlet reduction (TORe). a Gastrojejunal anastomosis (GJA) prior to commencement of argon plasma coagulation (APC). b Final bite of the single purse-string suture after completion of APC. c Performing the second suture of the DPSP procedure. Both trailing sutures head towards the mucosa on the right side of the image, while the suture remains attached to the needle driver. d Completion of the second purse-string suture. The needle of the first suture is seen in position and the needle of the second suture is going to be released almost adjacent to the first suture. e Through-the-scope (TTS) balloon placed through the GJA; the cinch is being loaded onto one suture and is being prepared to be deployed. The second suture can be seen running to the right of that currently not cinched. f Final appearance of the GJA after completion of TORe; the aperture appears to measure 8mm, as measured by the TTS balloon.
