Essential practice guidelines & consensus statements with global applicability in the field of endoscopy.
The aim of this position statement is to reinforce the key points of hygiene in digestive endoscopy. The present article details the minimum hygiene requirements for reprocessing of endoscopes and endoscopic devices, regardless of the reprocessing method (automated washer-disinfector or manual cleaning) and the endoscopy setting (endoscopy suite, operating room, elective or emergency procedures).
A dedicated digestive disease endoscopy unit is structurally and functionally differentiating rapidly as a result of increasing diagnostic and therapeutic possibilities in the last 10–20 years. Publications with practical details are scarce, imposing a challenge in the construction of such a unit. A WEO working group discussed and outlined a practical approach for design and construction of a modern endoscopy unit. Designing the layout is extremely important, necessitating thoughtful planning to provide comfort to the endoscopy staff and patients, and efficient data archiving and transmission.
Large, comprehensive reviews of transmission of infection during endoscopy have demonstrated that when currently accepted reprocessing practices are followed (in the absence of faulty equipment), there have been no reported episodes of transmission of infection. The fundamental importance of this document is that it represents a truly international consensus of over 150 gastroenterology and digestive endoscopy societies around the world, committed to a simple, uniform, and comprehensive standard to maximize compliance. A particularly novel aspect of the present guideline is the “cascade” concept, which attempts to reconcile a “gold standard” for endoscope reprocessing with a “minimum standard” for areas with more limited local resources.
Live demonstrations are traditional and popular methods of teaching practical digestive endoscopy, however criticisms have been expressed that patients may be at disadvantage by agreeing to examination by a visiting specialist, perhaps using unfamiliar equipment and in abnormal circumstances. WEO is strongly in favor of teaching by live demonstration, but believes that the safety and dignity of the patient is paramount.
WEO convened a working party to develop guidelines to help healthcare institutions in ensuring high quality endoscopic care. Chaired by Dr Douglas Faigel and Dr Peter Cotton, the working party of interested endoscopists from around the world sought to create international standards for credentialing and quality assurance. The resultant London WEO position statement was presented to the World Congress of Gastroenterology in London, on 25 November 2009, and published in the Journal Endoscopy in December, 2009. The position statement provides guidance on granting and renewal of privileges, determination of competency, and quality assurance and improvement.
Copyright 2003 by the American Society for Gastrointestinal Endoscopy. Reproduced with permission.
An intensive workshop designed to explore the utility and clinical relevance of the Japanese endoscopic classification of superficial neoplastic lesions of the GI Tract resulted in the Paris classification. This report summarizes conclusions of the workshop and proposes a general framework for the endoscopic classification of superficial lesions of the esophagus, stomach and colon. The clinical relevance of this classification is demonstrated in tables that show the relative proportion of each subtype in the esophagus, stomach and colon, assessing the risk of submucosal invasion and the risk of lymph node metastases.