Example of why learning and mastering imaging diagnosis is of paramount importance. This pt was referred to me with a non targeted antral Bx reported as Signet Ring Cell Cancer. A 4mm demarcated are was seen in antrum with typical corkscrew vessels of poorly differentiated (PD)…

Retroflexion in the ascending colon is a skill that is often overlooked. Yet it is an invaluable and important aspect of colonoscopy learning AND teaching as demonstrated by this recent colonoscopy of mine.
If not for retroflexion, I would have completely missed a polyp on this…

We wish all our Sri Lankan friends and everyone else, wherever you maybe, a very happy traditional Sri Lankan new year!
May this year be filled with good health, laughter and prosperity!

March and April are big months in the #GI and #Oncology realms as they are #ColorectalCancerAwarenessMonth and #EsophagealCancerAwarenessMonth , respectively.

I hold this month close to my ❤️and it's imperative to spread awareness: A 🧵

#GI Twitter #MedTwitter #MedEd #Surgery

This is my myotomy technique at POEM.
➡️Start with coagulation to Intermuscular space (00:30)
➡️This is to coagulate the fine vascular plexus in the IM space (01:05)
➡️Alternating coag and cut during myotomy (00:38)
➡️Always cut upwards towards tunnel but avoid significant…

Adequacy of preparation should not be a quality metric of colonoscopy alone. For a proper UGI examination, unobstructed mucosal views are essential. This can be easily achieved with NAC. At our unit, every patient of mine gets a pre-drink of NAC+Simethicone+water (100ml total)…

Can you deploy two OVESCO clips in one ulcer? Yes you can, and if indicated, you should!
This patient came to us with significant bleeding and a positive CTA with a blush in D1-D2 junction. Scope showed an ulcer with a NBVV in that difficult 1 o’clock position. Following the…

I’m very excited to participate as faculty in the Nottingham 12th Barrett’s Endotherapy course this June!
This will be the course that we will model our Royal Perth Hospital Barrett’s course on, to be held November this year.
I will be facilitating the hands on station on…

When you are performing high-end endoscopy, be it EMR/ESD or third space endoscopy, it pays to keep your eyes on the screen. When I first started I had to constantly look down to see where my diathermy pedals and irrigation pedals are as it constantly kept moving. This was…

Awesome Rectosigmoid EMR by our Fellow Ciaran Judge today. If you have a plan of attack, no EMR is too difficult
My tips
- Examine, examine, examine
- Start at the most difficult to approach part of polyp
- Or the dominant nodule/highest predicted dysplastic area
- Don't over…

Most uncoordinated and spasmodic Endoflip I have had so far in Achalasia POEM. This patient had Manometry findings of likely Type 3 Achalasia in evolution. Spasm was so tight in myotomy that I had to take time to avoid mucosal burn.
Post myotomy you can see how the most intense…

Today's Marathon ESD of a Dysplastic Foveolar Adenoma. Resection in the greater curve aspect is the hardest but so rewarding when it's completed.
I wish I had the dual bending gastroscope which would have made life much easier but managed to access the apex with traction…

Thanks sherman. It was definitely a collaborative effort. We just brought the team together. I must say you were very wise and informative on your live endoscopy session! Here’s to many more good things at Royal Perth Hospital!