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Workshops on "Innovative Therapeutic Endoscopy" for upper gastrointestinal tract diseases were held four times as the Japan Gastroenterological Endoscopic Society (JGES) Core Sessions at the 93rd to 96th Biannual Meetings of the JGES. A total of 48 research presentations (including two invited lectures) were reported, and various discussions were held on these topics. When the research presentations were categorized according to the therapeutic procedure, endoscopic submucosal dissection (ESD) was the most frequent with 28 presentations (58.3%), followed by laparoscopy endoscopy cooperative surgery (LECS) with six presentations (12.5%). When the research presentations were classified by the target organ of the therapeutic procedures, the duodenum was the most frequent with 26 presentations (54.1%), followed by the stomach with 13 presentations (27.1%). The most important issue was the establishment of a safe and reliable endoscopic resection method for duodenal lesions. Issues related to gastric ESD were establishing an efficient traction method and a method to prevent post‐ESD bleeding in high‐risk patients. Other important issues were establishment of an efficient traction method and methods of preventing delayed bleeding in high‐risk patients who undergo gastric ESD, expansion of indications for minimally invasive treatment using LECS for gastric cancer, the development of endoscopic full‐thickness resection (EFTR) for gastric submucosal tumors (SMTs), and improvement of per‐oral endoscopic myotomy (POEM) for esophageal achalasia and per‐oral endoscopic tumor resection (POET) for esophageal SMTs. Through the JGES Core Sessions, it is expected that the minimally invasive treatments using endoscopes developed in Japan will be further advanced. [ABSTRACT FROM AUTHOR]

Endoscopic submucosal dissection (ESD) is a rigorous and technically sophisticated method for removal of lesions within the gastrointestinal tract. Despite having advantages of en‐bloc resection of lesions, regardless of size, and widespread use in Japan and Asia, ESD has not become widely adopted in the USA for a variety of reasons. Based upon Japanese education and the master‐apprentice model, modification to the education system and additional techniques designed to facilitate broader adoption are required for trainees in the USA. This article will review the current state of education and training for ESD in the USA. [ABSTRACT FROM AUTHOR]

Keywords: early cancer detection; GI endoscopy training; JFE; JICA; OMED (WEO) EN early cancer detection GI endoscopy training JFE JICA OMED (WEO) 699 705 7 07/11/20 20200701 NES 200701 INTRODUCTION Endoscopes are now an indispensable medical device in digestive pathology, and digestive endoscopy is performed all over the world. One of the first training programs for foreign doctors in Japan was an early gastric cancer diagnosis course in Japan organized in the 1960s under the auspices of the then Overseas Technical Cooperation Agency (OTCA), now called the Japan International Cooperation Agency (JICA).3 Most of these trainee doctors came from developing countries. Officially, foreign doctors were not allowed by the Japanese government to do live demonstrations or perform endoscopy but that changed gradually to allow overseas doctors to practise endoscopy.1 Prof. Fujita's training philosophy was based on the concept of letting the trainees learn by doing what they want to do on their own, while providing them with support and guidance. ENDOSCOPY TRAINING CENTER AND LIVE DEMONSTRATIONS Years of experience admitting and training foreign doctors at various facilities convinced Prof. Fujita that Japan should establish an endoscopy training center exclusively for foreign doctors. [Extracted from the article]

This review is regarding the narrow-band imaging (NBI) system which has been developed at National Cancer Center Hospital East, Japan. The technology of the NBI system is based on modifying the spectral features by narrowing the bandwidth of spectral transmittance using various optical filters. The NBI system consists of three filters, 415–30 nm, 445–30 nm, and 500–30 nm, which are used as observing the fine capillaries in the superficial mucosa is essential to identify gastrointestinal neoplasms. The NBI system has been in development since 1999 and the first report of it's efficacy for gastrointestinal tract use was reported in 2001. In our pilot study, the NBI system may be sufficient to differentiate hyperplastic polyp from adenomatous polyp, and to visualize neoplasia with image processing in real-time during colonoscopy without the need for dye spraying. Herein, we propose the term ‘optical/digital chromoendoscopy’ using the NBI system and hope that this instrument will become standard endoscopy for in the 21st century. To estimate the feasibility and efficacy of using the NBI system for surveillance or screening examination, randomized control trials should be conducted in the future. [ABSTRACT FROM AUTHOR]

Although clinical trials using magnifying optical endoscopy have been reported, magnifying endoscopies have been remarkably developed in the period of electronic endoscopy. Magnifying electronic endoscopies with 80 or 100-fold magnification are used for routine endoscopic examination of upper gastrointestinal tract in Japan. Magnifying endoscopy is used to visualize the microstructure and microvascular architecture of gastrointestinal surface mucosa. Microsurface structure of the mucosa includes normal structure, changed structure by inflammation and biological response, and tumor-specific structure. Microvascular architecture includes normal vascular system and tumor microvessels. Magnifying endoscopy is starting to play an important role in diagnosis of any upper gastrointestinal diseases by assessment of magnified observation. Magnifying endoscopy holds a great deal of promise in the near future because magnifying endoscopic observation is approaching optical biopsy. [ABSTRACT FROM AUTHOR]

Examines the applications of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) in the gastrointestinal tract. Types of echo-endoscope for EUS FNA; Diagnostic purpose of EUS; Contraindications of endoscopy.

Background: The layered structure of the hollow organ visualized during endoscopic ultrasonography (EUS) has been interpreted in various ways and any consensus of opinion about how to interpret a layered structure is not yet established. This has caused confusion among physicians during discussions at academic forums or meetings. Therefore, it is necessary to establish a standard of interpretation as a basis for research and for such discussions. Purpose: To clarify a relationship between the layered structure in EUS and the histologic structure of the gastrointestinal wall. Method: To hold a meeting with participation from members eligible to pursue the purpose described. [ABSTRACT FROM AUTHOR]

The article presents information about the conference titled "Fifth Japan-Korea Joint Symposium on Gastrointestinal Endoscopy," which was held on May 16, 2006 in Tokyo, Japan. The event was a prominent one for the endoscopists in Japan and Korea. During the event professor Teruo Kouzu delivered the lecture on esophagus cancer. Professor Kyu Yong Choi presented a paper on colorectal cancer.

Endoscopic mucosal resection (EMR) is one of the endoscopic procedures for treatment of intramucosal cancer of the gastrointestinal tract. This method enables complete resection of a lesion, however, the size of lesions which can be resected en bloc has a limit. For lesions which can not be resected en bloc, endoscopic piecemeal mucosal resection (EPMR) are employed. However, it is often difficult to determine cancer invasion at holizontal and vertical cut end on pathological examination of resected specimens. Therefore, for the purpose of en bloc resection submucosal dissecting method of endoscopic mucosal resection (SDEMR) that is a method by which mucosa is dissected using some special devices after circumferential mucosal incision around the lesion was proposed. It enables us to resect large lesions which cannot be removed en bloc by EMR. Therefore, it is possible that this procedure is able to prevent residual cancer. Furthermore, sufficient pathological examination of resected specimens is possible, and it helps to determine a therapeutic plan after resection. It is now widely accepted as one of the endoscopic procedures for treatment of early gastric cancer, however, there have been few reports on its experience in the colorectum. Then, in order to consider the perspectives of SDEMR in the colorectum, the present status of it in Japan in August 2003 was analyzed and reviewed in this paper. [ABSTRACT FROM AUTHOR]