Successful Training in Gastrointestinal Endoscopy by Cohen Jonathan;

Author:Cohen, Jonathan; [Cohen, Jonathan]
Language: eng
Format: epub
Publisher: John Wiley & Sons, Incorporated
Published: 2022-02-01T00:00:00+00:00

17

Luminal Dilation Techniques (Strictures, Achalasia, Anastomotic, IBD)

Yi Jia1, Syed M. Abbas Fehmi2, and Michael L. Kochman1

1 University of Pennsylvania Health System, Philadelphia, PA, USA

2 University of California San Diego, San Diego, CA, USA

Introduction

“Dilation” when mentioned by a gastroenterologist refers to widening or opening an intraluminal stricture in a segment of the gastrointestinal (GI) tract. A stricture is an abnormal narrowing or constriction of the luminal GI tract, which may be in the form of an intraluminal, intrinsic mural, or extramural process.

The focus of this chapter will be on the technique of performing effective and safe dilation in the luminal GI tract. We will comment on the skill set required to perform this procedure, how to best acquire this skill set, and pearls on mastering the technique and propose some measures to assess the proficiency of an endoscopist in performing dilation. We will concentrate on making the concepts of dilation clear rather than focusing on any specific device type. The small differences that exist between similar devices manufactured by different companies and between the categories of devices are always changing, and as long as the technique is understood, one can easily adapt to new technology device iterations. Lastly, we shall not be covering dilation of the pancreaticobiliary system as this will be covered in a dedicated chapter. Likewise, discussion regarding the management of complications, the efficacy data of different techniques, and techniques for stricture management other than dilation are beyond the scope of this chapter.

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