Sivananthan A, Kerry G, Darzi A, Patel K, Patel N. Orientation in upper gastrointestinal endoscopy—the only way is up. World J Gastrointest Endosc 2023; 15(3): 146-152 [PMID: 37034971 DOI: 10.4253/wjge.v15.i3.146]
Corresponding Author of This Article
Arun Sivananthan, BSc, MBBS, Doctor, Department of Surgery and Cancer, Imperial College London, Praed Street, London W2 1NY, United Kingdom. arun.sivananthan@nhs.net
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Mar 16, 2023; 15(3): 146-152 Published online Mar 16, 2023. doi: 10.4253/wjge.v15.i3.146
Orientation in upper gastrointestinal endoscopy—the only way is up
Arun Sivananthan, Georgina Kerry, Ara Darzi, Kinesh Patel, Nisha Patel
Arun Sivananthan, Ara Darzi, Nisha Patel, Department of Surgery and Cancer, Imperial College London, London W2 1NY, United Kingdom
Georgina Kerry, Liver Intensive Care Unit, King’s College Hospital NHS Foundation Trust, London SE5 9RS, United Kingdom
Kinesh Patel, Gastroenterology, Chelsea and Westminster NHS Foundation Trust, London SW10 9NH, United Kingdom
Author contributions: Sivananthan A, Kerry G drafted and designed the work; Darzi A, Patel N, and Patel K conceptualised, revised and approved the work; Sivananthan A and Kerry G jointly contributed equally to the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the Imperial College London institutional review board.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Data sharing statement: All data is available as appendices and may be shared.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arun Sivananthan, BSc, MBBS, Doctor, Department of Surgery and Cancer, Imperial College London, Praed Street, London W2 1NY, United Kingdom. arun.sivananthan@nhs.net
Received: November 21, 2022 Peer-review started: November 21, 2022 First decision: January 2, 2023 Revised: January 15, 2023 Accepted: February 21, 2023 Article in press: February 21, 2023 Published online: March 16, 2023
ARTICLE HIGHLIGHTS
Research background
Orientation within the upper gastrointestinal (UGI) tract is challenging due to the flexible nature of the endoscope. There is limited data assessing endoscopist's ability to orient themselves to UGI landmarks.
Research motivation
The ability to accurately identify landmarks is important to allow accurate reporting of UGI lesions and location. Accurate reporting can be important in further therapy and prognostication in UGI bleeds.
Research objectives
To evaluate endoscopists’ ability to spatially orientate themselves within the UGI tract.
Research methods
A cross sectional descriptive study elicited, using an anonymised survey, the ability of endoscopists to orientate themselves within the UGI tract.
Research results
The majority of endoscopists surveyed were unable to identify key landmarks within the UGI tract. Experienced endoscopists were significantly more likely to identify landmarks in the oesophagus, stomach and duodenal bulb than novice endoscopists.
Research conclusions
Endoscopic orientation appears to improve with experience yet there are some areas still not well recognised. This has potential considerable impact on post-endoscopic management of patients with posterior duodenal ulcers being more likely to perforate and associated with a higher rebleeding risk.
Research perspectives
We suggest the development of a consensus statement on endoscopic description.
