Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Boškoski, Ivo; Pontecorvi, Valerio; Huberty, Vincent; Maselli, Roberta; Gölder, Stefan K.; Král, Jan; Samanta, Jayanta; Patai, Árpád V.; Haidry, Rehan; Hollenbach, Marcus; Pérez-Cuadrado-Robles, Enrique; Silva, Marco; Messmann, Helmut; Tham, T. C. K.; Bisschops, Raf

doi:10.1055/a-2003-5818

Cited by 9 publications

(6 citation statements)

References 93 publications

(99 reference statements)

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“…Any publications emerging during the Delphi process and manuscript writing were also considered for inclusion. Statements were drafted based on this evidence and subjected to an appraisal using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework [1,[3][4][5][6][7]10]. When a paucity of evidence was noted in an aspect of training that was deemed important, the groups relied on expert opinion to develop statements that were then fed into the Delphi process.…”

Section: Methodsmentioning

confidence: 99%

“…In 2017, the ESGE board convened the Curricula Working Group, which was responsible for developing curricula that defined the minimum training standards for more advanced and therapeutic endoscopic practice that may often go beyond the core endoscopy training curricula in each country. This process has been outlined previously [2] and Position Statements on six endoscopy topics have been already published [1,[3][4][5][6][7]. how competence should be defined and evidenced before independent practice.…”

Section: Introductionmentioning

confidence: 99%

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Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Badaoui,

Teles de Campos,

Fusaroli

et al. 2023

Endoscopy

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Main RecommendationsThe European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in diagnostic endoscopic ultrasound (EUS). This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in diagnostic EUS. This curriculum is set out in terms of the prerequisites prior to training; the recommended steps of training to a defined syllabus; the quality of training; and how competence should be defined and evidenced before independent practice. 1 Trainees should have achieved competence in upper gastrointestinal endoscopy before training in diagnostic EUS. 2 The development of diagnostic EUS skills by methods that do not involve patients is advisable, but not mandatory, prior to commencing formal training in diagnostic EUS. 3 A trainee’s principal trainer should be performing adequate volumes of diagnostic EUSs to demonstrate maintenance of their own competence. 4 Training centers for diagnostic EUS should offer expertise, as well as a high volume of procedures per year, to ensure an optimal level of quality for training. Under these conditions, training centers should be able to provide trainees with a sufficient wealth of experience in diagnostic EUS for at least 12 months. 5 Trainees should engage in formal training and supplement this with a range of learning resources for diagnostic EUS, including EUS-guided fine-needle aspiration and biopsy (FNA/FNB). 6 EUS training should follow a structured syllabus to guide the learning program. 7 A minimum procedure volume should be offered to trainees during diagnostic EUS training to ensure that they have the opportunity to achieve competence in the technique. To evaluate competence in diagnostic EUS, trainees should have completed a minimum of 250 supervised EUS procedures: 80 for luminal tumors, 20 for subepithelial lesions, and 150 for pancreaticobiliary lesions. At least 75 EUS-FNA/FNBs should be performed, including mostly pancreaticobiliary lesions. 8 Competence assessment in diagnostic EUS should take into consideration not only technical skills, but also cognitive and integrative skills. A reliable valid assessment tool should be used regularly during diagnostic EUS training to track the acquisition of competence and to support trainee feedback. 9 A period of supervised practice should follow the start of independent activity. Supervision can be delivered either on site if other colleagues are already practicing EUS or by maintaining contacts with the training center and/or other EUS experts. 10 Key performance measures including the annual number of procedures, frequency of obtaining a diagnostic sample during EUS-FNA/FNB, and adverse events should be recorded within an electronic documentation system and evaluated.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Badaoui,

Teles de Campos,

Fusaroli

et al. 2023

Endoscopy

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“…Another argument supporting the use of TTS or OTS clips is their availability compared with suturing devices, which are available only in specialist centers performing bariatric procedures. Additionally, endoscopic suturing is an advanced technique requiring dedicated training [34], whereas clipping is part of basic training, although stent fixation is more challenging than a straightforward clip application for hemostasis.…”

Section: Systematic Reviewmentioning

confidence: 99%

Success rates of fixation techniques on prevention of esophageal stent migration: a systematic review and meta-analysis

et al. 2023

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Background and study aims: Esophageal stenting (ES) is an important intervention for the management of malignant and benign dysphagia, with migration representing a common drawback. This systematic review with meta-analysis aimed to assess the benefit of ES fixation over non-fixated stenting. Patients Methods: A systematic research was performed in MEDLINE, Cochrane, Scopus and ClinicalTrials.gov databases until January 2023 for comparative studies evaluating the migration rates of ES after anchoring or not. The primary outcome included the difference of migration rates for fixated and non-fixated ES, with the rate of adverse events being secondary outcome. A subgroup analysis stratified the results based on different fixation techniques; suturing, over the scope clipping (OTSC) and trough the scope clipping (TTSC). Meta-analyses were based on random effects model and the results were reported as odds ratios (OR), with 95% Confidence Intervals (95%CI). Results: Ten studies (1014 patients) were included. The rates of stent migration were significantly lower after fixation [OR=0.20 (95%CI: 0.11-0.37; I2=59%, p=0.01)]. The rates of complications were similar between the fixation and control groups [OR=0.65 (95%CI: 0.28-1.52; I2=55%, p=0.06)]. In the subgroup analysis, all anchoring techniques preserved the superiority over non-fixated stents [suturing OR= 0.23 (95%CI: 0.10-0.53); OTSC OR= 0.31 (95%CI: 0.17- 0.58); TTSC OR=0.10 (95%CI: 0.03-0.38)], however only OTSC and TTSC groups achieved non-significant heterogeneity (I2=0%, p=0.67 and p=0.73, respectively). No difference between techniques was recorded considering the migration rates. Conclusion: Esophageal stent fixation is associated with significantly lower migration rates compared to the non-fixated stents regardless type and stenting indication.

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“…The ESGE endorses the need for validated training using simulators followed by hands-on experience gained through training in tertiary centers. (17) The use of advanced endoscopy by surgeons and gastroenterologists has become more important as a result of ongoing technology advancements and growing public awareness of endoscopic bariatric interventions. (18) Advancements in this field include a new robotic device that performs uniform gastric suturing for all patients.…”

Section: The Future Of Bariatric Endoscopymentioning

confidence: 99%

Gaps in obesity management in the UAE and the role of bariatric endoscopy

Alkhatry¹

2023

Front. Gastroenterol.

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The definitions of overweight and obesity include increased fat storage that might compromise one’s health. According to the World Health Organization (WHO), an adult is considered overweight if their Body Mass Index (BMI) is greater than or equal to 25, and obese if their BMI is greater than or equal to 30. Age must be taken into account when defining overweight and obesity in children. The prevalence of obesity and overweight was reported to be at 21% and 33%, respectively, in the Middle East region. As obesity incidence rises with ageing, those over 40 were found to have the highest prevalence of obesity and overweight. According to the Central Intelligence Agency’s World Factbook, the UAE has a prevalence rate of obesity of 31.7%, making it one of the top 20 nations in the world for high obesity rates in 2016. The prevalence of overweight and obesity in the UAE is estimated to have increased between 1989 and 2017 threefold.

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Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Cited by 9 publications

References 93 publications

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Success rates of fixation techniques on prevention of esophageal stent migration: a systematic review and meta-analysis

Gaps in obesity management in the UAE and the role of bariatric endoscopy

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