Donning a New Approach to the Practice of Gastroenterology: Perspectives From the COVID-19 Pandemic Epicenter

Sethi, Amrita; Swaminath, Arun; Latorre, Melissa; Behin, Daniel; Jodorkovsky, Daniela; Calo, Delia; Aroniadis, Olga C.; Mone, Anjali; Mendelsohn, Robin B.; Sharaiha, Reem Z.; Gonda, Tamas A.; Khanna, Lauren G.; Bucobo, Juan Carlos; Nagula, Satish; Ho, Sammy; Carr‐Locke, David L.; Robbins, David H.

doi:10.1016/j.cgh.2020.04.032

Cited by 29 publications

(31 citation statements)

References 17 publications

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“…Non-urgent endoscopy should be postponed. [5][6][7] Similarly, already-scheduled endoscopy should be postponed by contacting patients via phone, email, or postal service. 8 CQ2.…”

Section: Regarding Endoscopy Schedulingmentioning

confidence: 99%

Clinical Questions and Answers on Gastrointestinal Endoscopy during the Novel Coronavirus Disease 2019 pandemic

Furuta

Irisawa

Matsumoto

et al. 2020

Digestive Endoscopy

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Some situations may require endoscopy during the COVID‐19 (Coronavirus Disease 2019) pandemic. Here, we describe the necessary precautions in the form of clinical questions and answers (Q&A) regarding the safe deployment of gastrointestinal endoscopy in such situations while protecting endoscopy staff and patients from infection. Non‐urgent endoscopy should be postponed. The risk of infection in patients should be evaluated in advance by questionnaire and body temperature. The health of staff must be checked every day. Decisions to employ endoscopy should be based on the institutional conditions and aims of endoscopy. All endoscopic staff need to wear appropriate personal protective equipment (PPE). The endoscope and other devices should be cleaned and disinfected after procedures in accordance with the relevant guidelines. Optimal management of the endoscopy unit is required. Endoscopy for infected patients or those with suspected infection demands exceptional caution. When a patient who undergoes endoscopy is later found to have COVID‐19, the members of staff involved are considered exposed to the virus and must not work for at least 14 days if their PPE is considered insufficient. When PPE resources are limited, some equipment may be used continuously throughout a shift as long as it is not contaminated. Details of the aforementioned protective measures are described.

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“…Non-urgent endoscopy should be postponed. [5][6][7] Similarly, already-scheduled endoscopy should be postponed by contacting patients via phone, email, or postal service. 8 CQ2.…”

Section: Regarding Endoscopy Schedulingmentioning

confidence: 99%

Clinical Questions and Answers on Gastrointestinal Endoscopy during the Novel Coronavirus Disease 2019 pandemic

Furuta

Irisawa

Matsumoto

et al. 2020

Digestive Endoscopy

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“…However, the threat of healthcare-associated infections and the recent lockdown of endoscopy provision due to SARS-CoV-2 has prompted a careful look into other ways of dealing with endoscopy requests [ 96 ]. UGI endoscopy remains an aerosol-generating procedure, due to the potential for retching, coughing and open airway suction use.…”

Section: Endoscopy Services In the Covid-19 Era: Call For Innovatimentioning

confidence: 99%

Frontiers of Robotic Gastroscopy: A Comprehensive Review of Robotic Gastroscopes and Technologies

Marlicz

Ren

Robertson

et al. 2020

Cancers

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Upper gastrointestinal (UGI) tract pathology is common worldwide. With recent advancements in robotics, innovative diagnostic and treatment devices have been developed and several translational attempts made. This review paper aims to provide a highly pictorial critical review of robotic gastroscopes, so that clinicians and researchers can obtain a swift and comprehensive overview of key technologies and challenges. Therefore, the paper presents robotic gastroscopes, either commercial or at a progressed technology readiness level. Among them, we show tethered and wireless gastroscopes, as well as devices aimed for UGI surgery. The technological features of these instruments, as well as their clinical adoption and performance, are described and compared. Although the existing endoscopic devices have thus far provided substantial improvements in the effectiveness of diagnosis and treatment, there are certain aspects that represent unwavering predicaments of the current gastroenterology practice. A detailed list includes difficulties and risks, such as transmission of communicable diseases (e.g., COVID-19) due to the doctor–patient proximity, unchanged learning curves, variable detection rates, procedure-related adverse events, endoscopists’ and nurses’ burnouts, limited human and/or material resources, and patients’ preferences to choose non-invasive options that further interfere with the successful implementation and adoption of routine screening. The combination of robotics and artificial intelligence, as well as remote telehealth endoscopy services, are also discussed, as viable solutions to improve existing platforms for diagnosis and treatment are emerging.

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“…Procedural volumes were reduced by as much as 80% to 90% in some centers. 29 A US survey showed 65% of endoscopy units were operating at less than 10% of their usual volume, with important procedures such as screening colonoscopies being postponed in 97% of centers. 30 In some institutions, endoscopy units were converted to COVID-19 units and endoscopy staff redeployed to care for COVID-19-positive patients.…”

Section: ■ Performing Endoscopy During the Pan-demicmentioning

confidence: 99%

COVID-19 in patients with IBD and pancreaticobiliary disorders

Ouali

Philpott

Vargo

et al. 2020

CCJM

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Donning a New Approach to the Practice of Gastroenterology: Perspectives From the COVID-19 Pandemic Epicenter

Cited by 29 publications

References 17 publications

Clinical Questions and Answers on Gastrointestinal Endoscopy during the Novel Coronavirus Disease 2019 pandemic

Clinical Questions and Answers on Gastrointestinal Endoscopy during the Novel Coronavirus Disease 2019 pandemic

Frontiers of Robotic Gastroscopy: A Comprehensive Review of Robotic Gastroscopes and Technologies

COVID-19 in patients with IBD and pancreaticobiliary disorders

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