Upper GI Lesion Assessment: One Good Look Saves Low-Value Biopsies
The technical heart of the upper GI day, built as three chapters — one per territory. A disciplined look reduces low-yield sampling and its downstream pathology cost; it never removes the mapping protocols guidelines still require.
Running order (indicative)
- Head
- Prof David Tateanchors the studio throughout
- Talk 1
- Prof Arnaud LemmersThe Systematic Examination: Structured Inspection With Virtual Chromoendoscopy
- Talk 2
- Prof Alanna EbigboBeyond Seattle: Barrett's Imaging, Targeted Biopsy and What AI Adds
- Talk 3
- Prof Gianluca EspositoMapping With Intent: Gastric Intestinal Metaplasia, EoE and Targeted Sampling
- Live case
- Prof Alanna EbigboProf Michael BretthauerSystematic upper GI lesion assessment (oesophagus + stomach) with advanced imaging
- Live case
- Prof Arnaud LemmersProf Matthew RutterEarly gastric neoplasia — EMR vs ESD (resection technique stratification)
- Discussion
- Allremaining session time
The session, as written
Chapter 1 — The systematic look. Structured inspection through the whole upper GI tract with virtual chromoendoscopy used deliberately rather than decoratively — how a systematic examination targets sampling and cuts the random biopsies that clog pathology without changing management.
Chapter 2 — The oesophagus and Barrett's. (Ebigbo). Where high-definition imaging genuinely replaces sampling, where Seattle still applies, why the visible lesion goes to resection rather than re-biopsy — and the future of AI in Barrett's, from Europe's leading AI-Barrett's group.
Chapter 3 — The stomach. (Esposito). Mapping with intent: gastric cleanliness first, intestinal metaplasia by Sydney protocol, eosinophilic oesophagitis by six biopsies from two levels, the right jars, and nothing else.
Live case 1 — a full systematic assessment. Narrated in real time, the audience predicting the biopsy targets before the reveal — deliberately not a Barrett's.
Live case 2 — an early gastric neoplasm. Assessed for resection-technique stratification: EMR here, ESD, or refer — the upper-GI resection decision folded in where the lesion actually appears.
