Say No to the Knife! · 2019. 10. 22. · Ip 2c Is 2b . Team (JNET) classification Type 2B Variable...

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Say No to the Knife! New Frontiers in Colon Polyp Management David L. Diehl, MD, FASGE Geisinger Medical Center, Danville, PA

Transcript of Say No to the Knife! · 2019. 10. 22. · Ip 2c Is 2b . Team (JNET) classification Type 2B Variable...

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Say No to the Knife!

New Frontiers in Colon Polyp Management

David L. Diehl, MD, FASGE

Geisinger Medical Center, Danville, PA

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Myths, misunderstandings, barriers…that may lead to unnecessary surgery

• Current guidelines recommend referral to advanced endoscopist for large/difficult polyps, but not always happening.

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Is the lesion “depressed” in the center?

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EMR ESD

Procedure time shorter longer

Expertise required ++ ++++

En-bloc resection only if small enough,

generally <2cm

yes

Expertise required ++ ++++

Cost of devices $ $$$

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20X 40X

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OTSC (over the scope clip) for closure of perforation

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