While the standards of practice vary from country to country, there was broad agreement among participants regarding most issues pertaining to sedation during endoscopy.

Background Endoscopic removal of foreign bodies, coagulated blood or necrotic debris is sometimes challenging and time consuming, also due to inadequate endoscopic instruments. Therefore, new devices are needed to overcome current limitations. Methods The OTSG is a new grasping tool that can be attached to any standard gastroscope. It has been developed for endoscopic removal of larger particles. We present retrospective data of five patients treated with the device for various indications (necrosectomy. bolus impaction, removal of blood clots). Results In two patients the OTSG was used for direct endoscopic necrosectomy after severe pancreatitis through a lumen-apposing metal stent. The other patients had a massive blood clot in the esophagus after endoscopic submucosal dissection, or aphagia due to large meat chunks clogging the esophagus, respectively. The OTSG has been used in all cases with technical success and without any procedure associated complications. Conclusion The OTSG appears to be a useful device for endoscopic removal of larger particles, blood clots or necrotic debris. Preliminary experience shows that the device is effective and easy to apply.

High-fidelity simulation uses simulators that combine all of the physiological and pharmacological responses of a human in a manikin. These simulators change and respond to the users and trainees. Using simulators for teaching sedation in the field of gastroenterology unifies all the advantages of manikins. To understand the pharmacological and pharmacodynamical principles of drugs used for sedation in different clinical scenarios, such as cardiopulmonary diseases, a high-fidelity simulator is extremely useful. Respiratory complications and airway problems are the main side effects when using sedatives. To overcome these problems, exercise of precautionary measures are highly demanded to avoid hazards. High-fidelity simulation is increasingly being used for the development of crisis resource management. There are still limitations in using simulators for education and training. At present, applying simulation for teaching is expensive. The start-up costs and the expenses for instructors and technicians are high. Moreover, no direct evidence has demonstrated that simulation training improves actual patient safety outcome and, therefore, a lot of research in this field remains to be done. Even so, confidence is growing in the validity of medical simulation as the training tool of the future.

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Ich glaube nicht, mit meinen Filmen etwas bewirken zu können. Andererseits ist eine Wirkung nicht auszuschließen. Welcher Art diese sein könnte, ist kaum zu ergründen und muß mir gleichgültig sein. Ich darf das Motto, das gerade auf dem Tisch liegt, vermitteln. Ein anderes Mal ist es ein anderes, das auf das jetzige antwortet. Es ist sozusagen eine Entwicklung zu konstatieren, die immer außer Kontrolle, doch stringent erscheint. Das wenige, das andere an Verstand haben, fehlt mir. Dem Puls der Zeit, der Gesellschaft, kann man sich nicht entziehen. Darf ich es osmotische Kommunikation nennen? Diese ständige Kommunikation nötigt mich, Filme zu machen. Auf einen kommerziellen Erfolg kann ich dabei nicht achten. Als Erfolg möchte ich bezeichnen, wieder einen Film machen zu können, aus -wenn man so will -inneren Gründen. Mit den Finanzen komme ich dabei immer zurecht, weil, wenn ich das Richtige mache, sich eine gewisse Tüchtigkeit einstellt. Meine Arbeit ist ein Beispiel, mehr nicht.