Raf Bisschops

• M.D. , PhD.
• Head of Department at KU Leuven

Main Recommendations Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure that has become a first-line treatment for esophageal achalasia and other esophageal spastic disorders. Structured training is essential to optimize the outcomes of this technique. The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the n...

and Recommendation This statement conveys the European Society of Gastrointestinal Endoscopy (ESGE) position on the use of computer-aided detection (CADe) with artificial intelligence (AI) during colonoscopy for colorectal cancer (CRC) screening or surveillance. The ESGE position is informed by the BMJ Rapid Recommendation initiative and the approa...

Main Recommendations At a population level, the European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter and Microbiota Study Group (EHMSG), and the European Society of Pathology (ESP) suggest endoscopic screening for gastric cancer (and precancerous conditions) in high-risk regions (age-standardized rate [ASR] > 20 per 100...

A growing number of studies aim to evaluate gastrointestinal (GI) endoscopy services from the perspective of their environmental impact. However, there are currently no guidelines or frameworks which provide specifically for the reporting of endoscopy sustainability studies, and a variety of metrics and assessment tools have been employed in the li...

Background Colorectal polypectomy is operator dependent, with variable rates of complete resection. The currently available assessment tools do not provide specific competency-based evaluation of provider technique. We aimed to validate the Global Polypectomy Assessment Tool (GPAT), a novel competency assessment tool for colorectal polypectomy. Met...

Single-wavelength endoscopy (SWE) has shown promising results in assessing histological disease activity in ulcerative colitis. Our objective was to validate the real-time performance of a bedside prototype of SWE computer-aided diagnosis (CAD) as proof of concept. A bedside module for real-time use evaluated histological disease activity when endo...

Post-endoscopic resection (ER) management of high risk T1 esophageal adenocarcinoma (EAC) is debated, with conflicting reports on lymph node metastasis (LNM). We aimed to assess outcomes following radical ER for high risk T1 EAC. We identified patients who underwent radical ER (tumor-negative deep margin) of high risk T1 EAC, followed by surgery or...

Background Virtual Chromoendoscopy (VCE) is pivotal for assessing activity and predicting outcomes in Ulcerative Colitis (UC), though inter- and intra-observer variability and the need for expertise persist. Artificial intelligence (AI) has the potential to offer standardised VCE-based assessment. This study introduces a novel AI model to detect, g...

Background Novel colorectal cancer endoscopic surveillance techniques for inflammatory bowel disease (IBD) have recently been developed. Aims Compare the efficacy of currently available techniques for dysplasia detection in colonic IBD. Methods We conducted a systematic literature search from inception to March 2024 for randomized controlled tria...

Background and study aims Long-standing ulcerative colitis (UC) is associated with an increased risk of developing colorectal neoplasia. Both dye-based chromoendoscopy (DCE) and virtual chromoendoscopy (VCE) increase detection of neoplastic lesions. In this prospective randomized controlled trial (RCT), we compared the neoplasia detection rate betw...

Introduction Ulcerative colitis (UC) management employs a strategy targeting histological and endoscopic remission. Correlation of white-light endoscopy (WLE) scores with histological activity is limited. Single-wavelength endoscopy (SWE) addressing microvascular changes reflecting histological disease activity, may better assess histological remis...

Objectives The performance of a high quality esophagogastroduodenoscopy (EGD) is dependent on the mucosal cleanliness. Recently, the PEACE scale was created to assess degree of mucosal cleanliness during EGD. The aim of this study was to validate this scoring system in a cohort of international endoscopists. Methods 39 EGD videos, with different d...

Artificial intelligence (AI) holds significant potential for enhancing quality of gastrointestinal (GI) endoscopy, but the adoption of AI in clinical practice is hampered by the lack of rigorous standardisation and development methodology ensuring generalisability. The aim of the Quality Assessment of pre-clinical AI studies in Diagnostic Endoscopy...

Peroral endoscopic myotomy (POEM) is a novel technique within the field of third space endoscopy. The overarching principal is creation of a mucosal incision, careful dissection of the submucosal space using an electrosurgical knife to reach the muscularis (ie, tunneling), performing a controlled myotomy, and finally, closure of the mucosal incisio...

Statements 1 The European Society of Gastrointestinal Endoscopy (ESGE) adheres to the overarching principles of equality of opportunity, fair treatment, nondiscrimination, and diversity of health care professionals. 2 ESGE strongly supports the creation of collaborations within and between national and international endoscopy societies to dissemina...

Introduction: While piecemeal endoscopic mucosal resection (EMR) for T1a oesophageal adenocarcinoma is acceptable, enbloc-R0 excision is advocated for T1b disease as it may offer a potential cure and mitigate recurrence. Thus, distinguishing between T1a and T1b disease is imperative under current treatment paradigms. We sought to ascertain whether...

Introduction Minimally invasive endoscopic options are safe and effective alternatives to surgery for the treatment of symptomatic Zenker’s diverticulum (ZD). However, there is no consensus on the gold-standard approach. We compared the safety and efficacy of Zenker’s peroral endoscopic myotomy (Z-POEM), flexible diverticulotomy (FD), and rigid div...

Introduction A Zenker diverticulum (ZD) is an acquired sac-like outpouching that occurs at the pharyngo-oesophageal junction. When symptomatic, it is characterised by oropharyngeal dysphagia and regurgitation. Conventionally, they are treated by a surgical approach, which is effective but carries morbidity. Zenker peroral endoscopic myotomy (Z-POEM...

Introduction Zenker’s diverticulum (ZD) is associated with significant morbidity and reduced quality of life, predisposing to dysphagia, regurgitation, and aspiration pneumonia. Historically, surgery has been the preferred option but remains invasive with significant risk of complications. Endoscopic approaches offer a minimally invasive alternativ...

Introduction A Zenker diverticulum (ZD) is a herniation of the posterior pharyngeal wall, which is characterised by oropharyngeal dysphagia and regurgitation. Treatment aims to dissect the muscular septum of the cricopharyngeus to create a common cavity with the oesophageal lumen. Historically the main treatment has been surgical, but minimally inv...

Although colonoscopy is a routinely performed procedure, it is not devoid of challenges, such as the potential for perforation and considerable patient discomfort, leading to patients postponing the procedure with several healthcare risks. This review delves into preprocedural and procedural solutions, and emerging technologies aimed at addressing...

Background and aim Randomised trials show improved polyp detection with computer-aided detection (CADe), mostly of small lesions. However, operator and selection bias may affect CADe’s true benefit. Clinical outcomes of increased detection have not yet been fully elucidated. Methods In this multicentre trial, CADe combining convolutional and recur...

Main Recommendations 1 ESGE recommends cold snare polypectomy (CSP), to include a clear margin of normal tissue (1–2 mm) surrounding the polyp, for the removal of diminutive polyps (≤ 5 mm). Strong recommendation, high quality of evidence. 2 ESGE recommends against the use of cold biopsy forceps excision because of its high rate of incomplete resec...

Background This study evaluated the safety and efficacy of salvage endoscopic submucosal dissection (ESD) for Barrett’s neoplasia recurrence after radiofrequency ablation (RFA). Methods Data from patients at 16 centers were collected for a multicenter retrospective study. Patients who underwent at least one RFA treatment for Barrett’s esophagus and...

Background Lung transplantations are highly complex procedures, often conducted in frail patients. Through the addition of immunosuppressants, healing can be compromised, primarily leading to the development of bronchopleural fistulas. Although esophageal fistulas (EFs) after lung transplantation remain rare, they are associated with significant mo...

Background Gastrointestinal (GI) endoscopy is one of healthcare’s main contributors to climate change. We aimed to assess healthcare professionals’ attitudes and the perceived barriers to implementation of sustainable GI endoscopy. Methods The LEAFGREEN web-based survey was a cross-sectional study conducted by the European Society of Gastrointestin...

Background Red Density (RD) is an automated endoscopic tool that is developed for the objective evaluation of disease activity in ulcerative colitis (UC). The initial development integrated histological disease activity based on Robarts histological index (RHI) in the machine learning algorithm. New histological scores for UC have been developed si...

Background Assessment of mucosal healing as a key denominator in the treat-to-target strategy for managing ulcerative colitis remains challenging. To address this, objective evaluation of histological disease activity holds promise. Recent offline research shows encouraging results using a new deep-learning convolutional neural network based on sin...

Background Endoscopic resection has been recommended as preferable therapeutic approach for colitis associated neoplasia (CAN) in inflammatory bowel disease (IBD) patients. However, endoscopic resection of these lesions can be challenging due to ongoing inflammation, mucosal scarring, and submucosal fibrosis. We report long-term, single centre expe...

Main Statements This ESGE Position Statement provides structured and evidence-based guidance on the essential requirements and processes involved in training in basic gastrointestinal (GI) endoscopic procedures. The document outlines definitions; competencies required, and means to their assessment and maintenance; the structure and requirements of...

Purpose To translate the eight PROMIS ® GastrointestinaI Symptom Scales into Dutch–Flemish and to evaluate their psychometric properties. Methods This study consisted of two parts: (1) translation according to the Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology and (2) evaluation of psychometric properties: structu...