GIEQs Blog

A subepithelial lesion turns up in the second part of the duodenum and is referred for discussion. Reach for EUS? Resect it? Or can the diagnosis be made at the endoscope, in a couple of minutes, with the kit already in your hand? This short case works through the reasoning step by step — orientation against the major papilla, confirming the lesion is subepithelial rather than mucosal, testing mobility, the pillow sign, and the naked-fat sign that seals the diagnosis of lipoma.

Most teaching frames endoscopic complications as bad luck. Editor-in-Chief Dr David Tate argues the opposite in his introduction to Issue 5 of the ESGE Academy Video Journal: complications are predictable, clustering around four gaps in operator preparation. The complication rate is not a feature of the procedure — it is a feature of the operator.

A 24-minute survey of robotic platforms for endoscopic submucosal dissection — from EndoMASTER and EASE through STRAS, K-FLEX, Flex Robotic, Endomina, EndoFaster, GIFTS/ROBOPERA, Da Vinci SP, and EndoQuest ELS — with the Genidy 2026 meta-analysis, the drawbacks nobody wants to talk about, and a realistic clinical roadmap.

Expert live case documenting the complete management of a significant perforation following underwater polypectomy of a 30–35mm splenic flexure polyp. Running dual commentary narrates every decision — from haemostasis prioritisation and Kerr grasper use through to systematic high-density clip closure and real-time clip failure management.

This live case captures real-time identification and management of the Muscle Retraction Sign (MRS) during ESD of a biopsy-proven mid-oesophageal squamous cell cancer. Learn how directionality and asymmetric submucosal injection reveal deep SM invasion, how to navigate the EID intramuscular plane deliberately, and how to re-enter the submucosa to achieve a negative deep margin.

Expert live case teaching decision-making in complex polypectomy, featuring hybrid underwater ESD/EMR of a previously attempted duodenal lesion. Covers technique selection, intraoperative bleeding management with a systematic gravity-water-tamponade framework, and high-risk defect closure using mantis and retention clips. Includes candid discussion of when to transition from ESD knife to snare resection and the importance of patient positioning for optimal access.

Expert live case teaching piecemeal EMR of a large sessile transverse colon polyp, covering optical assessment with BLINK criteria, underwater and injection-assisted resection, intraprocedural bleeding management, and clip closure.

Watch the complete PRIME algorithm in action: from MRS detection and deep margin optical diagnosis to real-time EID plane selection. A 75-minute teaching case demonstrating how to achieve R0 resection in early rectal cancer with the REACT tool.