Video Journal of the ESGE Academy
Issue 05 - Adverse Events in Endoscopy
Welcome to the Video Journal of the ESGE Academy
An Innovative Platform for Endoscopic Education
Dear ESGE Member,
It is with great enthusiasm that we welcome you to the fifth edition of the Video Journal of the ESGE Academy.
This initiative was created with a clear and ambitious purpose: to serve as a comprehensive and enduring collection of high-quality video content dedicated to all aspects of endoscopic practice. Whether you are learning a technique for the first time or seeking to refine an established method, this journal offers clear, structured, and accessible educational resources to support your growth as an endoscopist.
Unlike much of the video material shared on social media—where we often see only the most advanced techniques performed by highly experienced practitioners or novel devices used in complex, edge-case scenarios—the Video Journal of the ESGE Academy offers something different. We focus on what lies beneath the surface of the iceberg: the essential techniques, fundamental procedures, and core knowledge that form the foundation of high-quality endoscopy. These are the building blocks that every practitioner, regardless of their experience level, must master.
Any endoscopic procedure can be featured here. Whether it is a groundbreaking innovation or a time-tested method dating back to the earliest days of endoscopy, we welcome it—provided it is presented with the clarity and structure that enable any viewer, regardless of prior exposure, to understand and apply it in their own practice. Each contribution should break the technique down into its constituent steps, illustrate the critical elements, and communicate the key concepts in a way that is practical, accessible, and immediately useful.
The Video Journal of the ESGE Academy will be published quarterly, with themes and topics announced three months in advance. If you are passionate about education and have a technique or concept to share, we warmly encourage you to submit your video for review. Submissions that meet our editorial standards and are selected for publication will be proudly showcased here on our platform.
We hope you find inspiration, knowledge, and value within these pages—and we look forward to building this educational journey together.
Welcome to the Video Journal of the ESGE Academy. Let’s advance endoscopy, one video at a time.
David Tate
Editor-in-chief
Section Introduction
Editor's Introduction — Adverse Events in Endoscopy
Complications are predictable: the four pillars of operator preparation
This introduction to Issue 5 of the ESGE Academy Video Journal, themed on adverse events in endoscopy, frames the issue around a single argument: complications are not bad luck — they are the predictable consequence of gaps in operator preparation. The video sets out four pillars on which a safe endoscopist is built — theoretical understanding, familiarity with materials, preparation and equipment in the room, and procedural excellence — and signposts the contributor segments that illustrate each one.
David Tate
University Hospital Ghent (UZ Gent), Gent, Belgium, Department of Gastroenterology & Hepatology.
Faculty of Medicine and Health Sciences, University of Gent, Gent, Belgium.
Section Upper GI
Adverse events in Upper GI Endoscopy
Not all adverse events bleed...some are simply being missed!
This video focuses on adverse events in upper gastrointestinal endoscopy, particularly missed diagnoses resulting from suboptimal technique and inadequate biopsy practices. It highlights key quality indicators from the 2025 Update of ESGE Performance Measures for upper gastrointestinal endoscopy, including the importance of adequate inspection time, optimal mucosal visibility (guided by validated visibility scales, e.g. the GRACE scale) and a systematic approach to examination. Through clinical examples, the video demonstrates how poor visualisation, an incomplete assessment and a failure to adhere to protocol-based biopsy strategies can result in pathological findings being overlooked. The video aims to emphasise that missed diagnoses are a critical but often under-recognised complication of endoscopy and to guide clinicians in improving diagnostic accuracy by enforcing strict adherence to guideline-based practices.
Alzbeta Hujova
Institute of Clinical and Experimental Medicine, Prague, Czech Republic.
Gianluca Esposito
Department of Medical-Surgical Sciences and Translational Medicine University Sapienza of Rome, Digestive Endoscopy Unit - Sant'Andrea Hospital, Rome, Italy.
Joao A. Cunha Neves
Gastroenterology Department, Unidade Local de Saúde do Algarve, Portimão, Portugal.
David Andreas Roser
Fellow at the Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany.
Clinician Scientist at Augsburg University, Augsburg, Germany.
Iatrogenic esophageal perforations
The ABC of Iatrogenic Esophageal Perforation Management
After watching this video presentation you will be informed about what to do in case you encounter an iatrogenic esophageal perforation. Next to immediate measures, different treatment options are explained, illustrated by two video cases.
Roos E. Pouw
Gastroenterologist at the Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands.
Francesco Vito Mandarino
Department of Gastroenterology and Gastrointestinal Endoscopy Division, IRCCS San Raffaele, Hospital Milan, Italy.
Ernesto Fasulo
Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Michele Montori
Clinic of Gastroenterology, Hepatology and Emergency Digestive Endoscopy, Università Politecnica delle Marche, Ancona, Italy.
Section Lower GI
Adverse events in lower GI endoscopy
How to manage perforations in lower GI
This video explains how to recognise and manage perforations in the lower gastrointestinal tract. It reviews the main risk factors for perforation and the use of the Sydney classification to identify and describe these events. Several intraprocedural perforations are shown, with examples of their endoscopic management. The video also discusses the choice of closure technique, with practical tips on how to achieve effective endoscopic closure. Finally, the management of capnoperitoneum is demonstrated, including how to recognise it during the procedure and how to treat it safely.
Maria-Eva Argenziano
University Hospital Ghent (UZ Gent), Gent, Belgium, Department of Gastroenterology & Hepatology.
Faculty of Medicine and Health Sciences, University of Gent, Gent, Belgium.
Clinic of Gastroenterology, Hepatology and Emergency Digestive Endoscopy, Università Politecnica delle Marche, Ancona, Italy
Pieter Jan Poortmans
University Hospital Ghent (UZ Gent), Gent, Belgium, Department of Gastroenterology & Hepatology.
Faculty of Medicine and Health Sciences, University of Gent, Gent, Belgium.
University Hospital Brussels (UZ Brussels), Brussels, Belgium, Department of Gastroenterology & Hepatology.
Andrea Sorge
Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Gastroenterology Unit, University Hospital of Padua, Padua, Italy.
George Chlorakis
Department of Gastroenterology, University Hospital of Heraklion, Greece.
Neasa Mc Gettigan
Department of Gastroenterology, Beaumont Hospital, Dublin, Ireland.
David Tate
University Hospital Ghent (UZ Gent), Gent, Belgium, Department of Gastroenterology & Hepatology.
Faculty of Medicine and Health Sciences, University of Gent, Gent, Belgium.
Section ERCP
ERCP Perforation - Prevention and Management
A practical guide to prevention, recognition, and management
Perforation in ERCP is rare, but its consequences demand preparation. This video equips endoscopists with the technical knowledge to prevent it, the clinical acumen to recognise it, and the systematic approach to manage it. Illustrated with real clinical cases, it brings the learning to life. Because in endoscopy, safety begins before the scope is inserted.
Srisha Hebbar
Department of Gastroenterology, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom.
Irina-Gabriela Diaconu
Gastroenterology Department, Helios Klinikum Krefeld; Krefeld, Germany.
Upcoming editions of the Video Journal of the ESGE Academy:
Issue 6: Characteristics of Different Endoscopic Equipment - September 17, 2026
Issue 7: Maximising the Quality of Therapeutic Endoscopy - January 15, 2027
Contributions to ESGE Academy Video Journal
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Welcome to the ESGE Academy app, your gateway to world-class education in gastrointestinal endoscopy. Designed exclusively for active ESGE members, this app provides free access to a vast library of educational resources curated by the European Society of Gastrointestinal Endoscopy.
The ESGE Academy app is available for iPhone and iPad using iOS/iPadOS 16 or newer.
