Endoscopy & Interventional GI

Third-space endoscopy has matured into a discipline of its own, with endoscopic submucosal dissection (ESD) increasingly preferred over EMR for high-risk early GI neoplasia and POEM established as a durable achalasia therapy. EndoFLIP impedance planimetry now guides both diagnosis and intra-procedural calibration. ERCP advances include digital cholangioscopy with electrohydraulic and laser lithotripsy for difficult stones, lumen-apposing metal stents for walled-off necrosis and gallbladder drainage, and EUS-guided gastroenterostomy. Bariatric endoscopy — endoscopic sleeve gastroplasty and intragastric balloons — is examined alongside GLP-1 perioperative aspiration risk and ASA guidance.