scholarly journals “An Odyssey of Third Space Endoscopy”—from Entry into the Tunnel to Entry into the Peritoneal Cavity

2019 ◽  
Vol 10 (03) ◽  
pp. 142-149
Author(s):  
Harshal S. Mandavdhare ◽  
Shubhra Mishra ◽  
Jayanta Samanta ◽  
Jimil Shah ◽  
Rakesh Kochhar
Keyword(s):  
Peritoneal Cavity ◽  
Paradigm Shift ◽  
Bowel Movement ◽  
Submucosal Tumor ◽  
Tumor Resection ◽  
Third Space ◽  
Esophageal Lumen ◽  
History Of ◽  
Endoscopic Myotomy ◽  
Per Oral

AbstractThe last decade has seen the growth of a completely new and exciting entity called the third space endoscopy (TSE) that has brought about a paradigm shift in the way we manage various disorders of the gastrointestinal tract. The journey started with per oral endoscopic myotomy (POEM) for achalasia cardia and within a decade the concept has been exploited to its best potential for disorders including submucosal tumor resection, pyloromyotomy for gastroparesis, complete division of septum without the risk of perforation in diverticular diseases of esophagus, restoration of esophageal lumen in long strictures, restoration of bowel movement in Hirschsprung’s disease, and then taking the concept to the next level of pure NOTES (natural orifice transluminal endoscopic surgery) by entering the peritoneal cavity and performing fundoplication. This review will discuss the history of TSE with brief discussion about the various applications and what has been achieved till present.

scholarly journals Experience and Technique for Zenker's Diverticulum Per Oral Endoscopic Myotomy: Z-POEM

2020 ◽  
Author(s):  
Eitan Podgaetz ◽  
Vani Konda
Keyword(s):  
Third Space ◽  
Zenker’S Diverticulum ◽  
Complication Rates ◽  
Short Term ◽  
Zenker's Diverticulum ◽  
Per Oral Endoscopic Myotomy ◽  
Endoscopic Myotomy ◽  
Invasive Techniques ◽  
Per Oral

Abstract Objective With the advent of minimally invasive surgery, incisionless surgery, and third-space endoscopy, the treatment for Zenker's diverticulum has also moved toward less invasive techniques Methods New incisionless per oral techniques can be applied for cricopharyngeal myotomy in Zenker's diverticulum. Results Five patients underwent Zenker's diverticulum per oral endoscopic myotomy (Z-POEM) without complications, minimal discomfort, and narcotic consumption, with complete resolution of their symptoms by history and Eckardt scores. Conclusions Z-POEM is performed entirely endoscopically with very little associated pain or complication rates, with short-term follow-up having excellent functional and symptomatic results.

Per-oral Endoscopic Myotomy and Other Applications of Third Space Endoscopy

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Harshal S. Mandavdhare ◽  
Shubhra Mishra ◽  
Antriksh Kumar ◽  
Jimil Shah ◽  
Jayanta Samanta ◽  
...  
Keyword(s):  
Third Space ◽  
Per Oral Endoscopic Myotomy ◽  
Endoscopic Myotomy ◽  
Per Oral

scholarly journals High prevalence of musculoskeletal symptoms and injuries in third space endoscopists: an international multicenter survey

2020 ◽  
Vol 08 (10) ◽  
pp. E1481-E1486
Author(s):  
Samuel Han ◽  
Hazem T. Hammad ◽  
Mihir S. Wagh
Keyword(s):  
Logistic Regression ◽  
Clinical Practice ◽  
Third Space ◽  
Musculoskeletal Symptoms ◽  
Multicenter Survey ◽  
High Prevalence ◽  
Endoscopic Myotomy ◽  
Long Term Impact ◽  
Per Oral

Abstract Background and study aims Third space endoscopy (TSE), including per-oral endoscopic myotomy and endoscopic submucosal dissection, is technically challenging and physically demanding. The aim of this study was to assess the prevalence and types of musculoskeletal symptoms and injuries (MSI) in third space endoscopists and its impact on clinical practice. Materials, Patients and methods A 22-item survey measuring endoscopist characteristics, procedure volumes, MSI, and its effect on clinical practice was distributed to endoscopists practicing TSE. Descriptive statistics were used to depict MSI. Logistic regression was used to identify predictors for MSI related to TSE. Results The survey was completed by 45 of 110 endoscopists (40.9 %) who received the survey, representing 10 countries across four continents. Thirty-one (69 %) endoscopists reported current MSI with 71 % (n = 22/31) believing these began after starting TSE, and 48.9 % (22/45) reporting more symptoms after TSE compared to endoscopic ultrasound/endoscopic retrograde cholangiopancreatography. Common MSI included the shoulders (42.2 %), back (37.8 %), neck (33.3 %), and wrist (24.4 %). Lower extremity MSI were also reported with foot symptoms (11.1 %) being most common. A minority required disability (2.2 %), change in endoscopy scheduling (6.7 %) or surgery (2.2 %). Only 15.6 % of endoscopists had received prior ergonomics training. Logistic regression revealed no significant predictors for MSI. Conclusions Over two-thirds of endoscopists performing TSE suffer from MSI, with many reporting onset of their symptoms after starting TSE in their practice. Further studies are needed to understand and reduce the risk of MSI in TSE given the growing demand for these procedures and the potential long-term impact of this occupational hazard.

The Beginnings of Islam in Afghanistan

2017 ◽  
Author(s):  
Arezou Azad
Keyword(s):  
Paradigm Shift ◽  
Political System ◽  
Cultural Practices ◽  
Eighth Century ◽  
Religious Context ◽  
Early Islam ◽  
History Of ◽  
Initial Conversion ◽  
The Way

Covering the period from 709 to 871, this chapter traces the initial conversion of Afghanistan from Zoroastrianism and Buddhism to Islam. Highlighting the differential developments in four regions of Afghanistan, it discusses the very earliest history of Afghan Islam both as a religion and as a political system in the form of a caliphate.  The chapter draws on under-utilized sources, such as fourth to eighth century Bactrian documents from Tukharistan and medieval Arabic and Persian histories of Balkh, Herat and Sistan. In so doing, it offers a paradigm shift in the way early Islam is understood by arguing that it did not arrive in Afghanistan as a finished product, but instead grew out of Afghanistan’s multi-religious context. Through fusions with Buddhism, Zoroastrianism, early Abrahamic traditions, and local cult practices, the Islam that resulted was less an Arab Islam that was imported wholesale than a patchwork of various cultural practices.

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