[Novelties in digestive endoscopy: three promising endoscopic procedures].

Area of Science:

• Gastroenterology
• Gastrointestinal Endoscopy
• Surgical Oncology

Background:

• Refractory gastro-esophageal reflux disease (GERD) poses a significant clinical challenge.
• Gastroparesis, encompassing diabetic, post-surgical, and idiopathic subtypes, requires advanced therapeutic options.
• Management of small pancreatic tumors often necessitates innovative approaches.

Purpose of the Study:

• To introduce and evaluate novel endoscopic interventions for challenging gastrointestinal and pancreatic conditions.
• To highlight the efficacy of anti-reflux mucosectomy/mucosal ablation (ARMS/ARMA) for refractory GERD.
• To present gastric peroral endoscopic myotomy (G-POEM) as a treatment for gastroparesis and endoscopic ultrasound-guided radiofrequency ablation (EUSRA) for pancreatic lesions.

Main Methods:

• Anti-reflux mucosectomy (ARMS) or mucosal ablation (ARMA) for refractory GERD without large hiatal hernia.
• Gastric peroral endoscopic myotomy (G-POEM), an endoscopic antro-pyloromyotomy, for various gastroparesis types.
• Endoscopic ultrasound-guided radiofrequency ablation (EUSRA) for selected small pancreatic tumors.

Main Results:

• ARMS/ARMA demonstrate efficacy in treating refractory GERD.
• G-POEM shows promise as an endoscopic antro-pyloromyotomy for gastroparesis.
• EUSRA offers a potential non-surgical alternative for specific pancreatic lesions.

Conclusions:

• Novel endoscopic techniques like ARMS, ARMA, G-POEM, and EUSRA expand treatment options for GERD, gastroparesis, and pancreatic tumors.
• These minimally invasive procedures provide effective alternatives to traditional surgical interventions in selected patient groups.