The Interventional Endoscopist

Description: In this episode of The Interventional Endoscopist, I dive divs into one of the most impactful developments in advanced GI care: the approval of dedicated Category I CPT codes for Endoscopic Submucosal Dissection (ESD). These long-awaited codes, one for upper GI and one for lower GI, go into effect on January 1, 2027 — and could finally unlock broader access, adoption, and reimbursement for ESD in the U.S. I discuss: The clinical value of ESD and why adoption has been slow How reimbursement barriers have held the technique back What Category I CPT code approval by the AMA actually means A detailed timeline of what happens between now and 2027 The role of the RUC, CMS, and commercial payers How GI practices, hospitals, ASCs, and coders should prepare Why this could signal a tipping point for training, education, and device innovation If you're performing ESD, planning to learn, or managing coding and billing for a GI practice, this episode is your roadmap.

In this episode of The Interventional Endoscopist, I sit down with Dr. Jessica Widmer—Division Chief of Gastroenterology at NYU Langone Hospital–Long Island—for an honest, insightful, and inspiring conversation. Dr. Widmer shares her journey from a small town in Pennsylvania to becoming a leader in interventional endoscopy. We discuss her training path, early exposure to ERCP and cholangioscopy, and her decision to pursue advanced training at Cornell. She reflects on mentors who shaped her career, including Dr. Stavros Stavropoulos and Dr. Michel Kahaleh, and offers practical tips on teaching and performing cholangioscopy and pancreatoscopy. The episode also touches on the evolution and future of GI, training Challenges women face in interventional endoscopy, and balancing demanding careers with family life. We discuss the value of mentorship and society involvement Whether you're an advanced fellow, practicing endoscopist, or simply curious about the human side of medicine, this conversation delivers wisdom, humor, and heart. Subscribe, rate, and share—and stay tuned for more episodes exploring the minds shaping the future of GI.   Link to the GOLD program: https://www.asge.org/home/education/advanced-education-training/leadership-development/gi-organizational-leadership-development-program

Join me as I welcome Fritz Haller, CEO and co-founder of Endolastic, to the podcast. Discover the fascinating journey of this medical device innovator, a former world champion, and Olympic coach in whitewater slalom.   Fritz discusses his transition from a decorated athletic career and early experiences in medical devices at Cook Medical to founding Endolastic. Learn about Endolastic's core technology: a customized band ligation device designed to tackle new applications in interventional endoscopy.  Fritz explains how Endolastic is using this "rubber band gun" to address conditions like GERD, Obesity (Band Gastroplasty), and Type 2 Diabetes (Duodenal Mucosal Resurfacing), offering simpler, more affordable, and accessible alternatives to existing procedures.   Hear about the technical differences of Endolastic's bands and barrels, including the innovative "window lock" design and calibrated compression. Fritz shares insights into the company's regulatory strategy, aiming for specific treatment indications after an initial launch.   Drawing on his diverse background, Fritz reflects on the nature of innovation, the lessons learned from past failures like the "scope doc," and the disruptive power of simple, effective solutions. He offers valuable advice for physicians and industry professionals looking to bring their innovative ideas to market, including navigating industry relationships, securing patents, and utilizing contract manufacturers. The conversation also delves into his perspective on leadership, emphasizing enthusiasm and coaching over traditional titles.   This episode is a must-listen for anyone interested in the future of interventional endoscopy, medical device innovation, unique career paths, and the intersection of athletic discipline and entrepreneurial spirit.

Episode 31, In this episode, we look at redefining Gastroenterology: Mentorship, Innovation, and the Future of Interventional Endoscopy with Dr. Srinadh Komanduri Episode Summary: In this episode of The Interventional Endoscopist, host Dr. Mankanwal Sachdev reconnects with his longtime mentor, Dr. Srinadh Komanduri of Northwestern University. The two dive into Dr. Komanduri's unique training path, his role in building Northwestern's interventional endoscopy program, and how the field of GI is shifting away from traditional definitions toward a more therapeutic and innovation-driven future. The conversation covers the launch of Northwestern's system-wide GI integration, the impact of tools like TissueCypher for risk stratification in Barrett's esophagus, and the critical need to rethink GI fellowship structure. They also touch on barriers to technology adoption, the role of AI in operational efficiency, and how innovation can (and must) scale beyond a few experts to change care across systems. Topics Covered: Dr. Komanduri's mentorship and hybrid fellowship experience Building an interventional GI network across 11 hospitals Moving beyond the “general GI” label Risk stratification and innovations in Barrett's esophagus care AI's role in reducing burnout and boosting clinical efficiency Future models for GI training and specialization Barriers to adoption and how to drive systemic innovation Sponsored by: Castle Biosciences – maker of TissueCypher®, a test to predict esophageal cancer risk in Barrett's esophagus

I am excited to share insights from the Interventional Endoscopist podcast featuring Dr. Sachin Wani! The discussion centered on Barrett's esophagus, and strategies to improve detection and risk stratification Key takeaways: • The rising incidence of esophageal adenocarcinoma makes early detection crucial. Yet, survival rates remain low, highlighting the need for improved strategies • PEEC and PEEN underscore the issue of missed lesions during endoscopy, emphasizing the need for high-quality exam. • PEEC (postendoscopy esophageal adenocarcinoma) refers to cancer detected before the next recommended surveillance endoscopy in patients with non-dysplastic Barrett's esophagus.  • PEEN (postendoscopy esophageal neoplasia) is a composite endpoint of high-grade dysplasia or cancer detected before the next recommended surveillance exam • A high-quality endoscopic exam is paramount, including meticulous inspection, standardized classification, and advanced imaging techniques like chromoendoscopy.  • A 10-step approach to a high-quality exam includes identifying landmarks, spending adequate time inspecting the Barrett's segment, cleaning the distal esophagus, and using high-definition white light endoscopy and virtual chromoendoscopy • While the Seattle biopsy protocol is standard, it has limitations due to sampling errors • WATS (Wide Area Transepithelial Sampling) can enhance neoplasia detection as an adjunct to the Seattle protocol by sampling the entire Barrett's segment. • AI (artificial intelligence) holds promise for lesion detection, improved diagnostic accuracy, and quality assessment of endoscopic exams. AI platforms may help identify visible lesions and predict histology, as well as assess the quality of the endoscopic examination. • The Tissue Cypher test can aid in risk stratification by analyzing biomarkers to predict the risk of progression to high-grade dysplasia. It can also predict prevalent high-grade dysplasia or cancer.  • Dr. Wani also shared his journey into medicine, influenced by his family, and the challenges faced by foreign medical graduates. A key message was the importance of continuous improvement in endoscopic techniques and the integration of new technologies to combat esophageal adenocarcinoma   This episode was sponsored by Castle Biosciences the makers of the TIssue Cypher Test.

Join us for a deep dive into the world of endoscopic oncology with Dr. Toufic Kachaamy! This episode explores the rapidly evolving field of endoscopic oncology, highlighting its importance in cancer care and the need for multidisciplinary collaboration. In my second visit with Dr. Kachaamy discusses his innovative endoscopic oncology course, now in its fourth year, designed to bridge the gap between gastroenterology and oncology. Learn about the course's unique format, diverse faculty, and focus on cutting-edge topics, including early cancer detection, multidisciplinary strategies for managing metastasis, and organ preservation techniques. Don't miss this insightful conversation with a leader in the field!     If you want to join us at the course here is the registration link : https://cme.cityofhope.org/content/2025-annual-advances-and-innovations-endoscopic-oncology-and-multidisciplinary#group-tabs-node-course-default6

In episode 29 of the Interventional Endoscopist Podcast, join us for an insightful conversation with Dr. Legett from the Mayo Clinic, Rochester. We delve into his extensive experience in treating esophageal disorders, focusing on Barrett's esophagus. Dr. Legett shares his journey and training at Mayo Clinic, highlighting his expertise in leveraging artificial intelligence and precision medicine, such as the TissueCypher test, to enhance early detection and management of Barrett's esophagus and esophageal cancer. The episode explores the challenges of diagnosing dysplasia, the transformative potential of AI in standardizing pathology, and improving patient care. Additionally, we discuss the role of molecular profiling in risk stratification and emphasize the critical need for ongoing research to optimize management strategies for Barrett's esophagus. This episode is proudly sponsored by Castle Biosciences, the innovators behind TissueCypher, a test designed to predict esophageal cancer risk in patients with Barrett's esophagus.

In this episode of The Interventional Endoscopist Podcast, Dr. Stuart Akerman joins host Dr. Mankanwal Sachdev to explore the evolving role of AI in gastroenterology and endoscopy. They dive into AI's impact on polyp detection, note writing, and patient engagement, and how it enhances both efficiency and care quality. Dr. Akerman reviews leading AI systems like GI Genius, Magenta, and Scalp, while discussing their potential to improve adenoma detection rates and reduce withdrawal times. Together, they address ethical concerns, AI fatigue, and the importance of balancing technology with human touch. Tune in to hear how AI is reshaping the future of GI practice.

In this episode of The Interventional Endoscopist, Dr. Mankanwal Sachdev and Dr. Stuart Akerman explore the pivotal role of endoscopic ultrasound (EUS) in ambulatory surgical centers (ASCs) and its impact on both patient care and physician work-life balance. Dr. Akerman, a physician advisor for Endosound, shares how EUS has transformed his practice. He also reflects on his unique journey from a career in finance to becoming a physician, his mentorship under Dr. Mickey Goldschmidt, and his current role at Digestive Health Associates of Texas (DHAT), where he balances general gastroenterology with interventional endoscopy. This episode highlights the value of mentorship and the evolving role of medical technology in enhancing patient outcomes   This is part one of a special two part episode

In this episode of The Interventional Endoscopist Podcast, I sit down with Dr. Doug Adler, Director of the Center for Advanced Therapeutic Endoscopy at Porter Adventist Hospital. We discuss his transition from a 20-year academic career to a hybrid practice model, blending private practice with academic responsibilities—a trend gaining traction among interventional endoscopists. Dr. Adler shares his journey from medical training at Cornell and the Mayo Clinic to becoming a leader in therapeutic endoscopy. He reflects on his mentors, his passion for procedural medicine, and the future of the field, including exciting new techniques like endoscopic retrograde appendiceal therapy (ERAT). This episode offers valuable insights for young physicians navigating career transitions, mentorship, and the evolving landscape of interventional endoscopy.

In the latest episode of The Interventional Endoscopist Podcast, Dr. Jason B. Samarasena, a prominent figure in the field of endohepatology, shares insights into his background and the innovative developments in this emerging specialty. Dr. Samarasena delves into the evolution of endohepatology, highlighting the potential it holds for transforming patient care. A significant portion of the discussion focuses on Endoscopic Ultrasound-guided Portal Pressure Gradient (EUS-PPG), a cutting-edge procedure that Dr. Samarasena helped to pioneer. He explains the technique, its clinical applications, and its importance in assessing portal hypertension non-invasively. This conversation offers valuable perspectives on the future of endoscopic interventions in hepatology, emphasizing the role of interdisciplinary collaboration and technological advancements in improving patient outcomes.     Links: Dynamic suction: a novel technique to optimize EUS-guided liver biopsy My method for liver biopsy processing Dr. Samarasena's Linkedin profile EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study Youtube Video of Podcast    

In this exciting episode of "The Interventional Endoscopist," I sit down with Scott Haack, a renowned inventor and innovator in the gastrointestinal (GI) space. With a career dedicated to advancing endoscopic technology and improving patient outcomes, Scott shares his journey, the challenges he has faced, and his vision for the future of GI procedures. Tune in as Scott delves into the intricacies of his groundbreaking work, offering insights into the latest innovations and the impact they have on both practitioners and patients. Whether you're an endoscopist, a medical professional, or simply fascinated by medical technology, this episode promises to be an enlightening and inspiring listen. Join me for a deep dive into the world of GI innovation and discover what drives the passion behind Scott Haack's remarkable contributions to the field.   Video of Podcast: https://youtu.be/p2p0gGiVLHI for those who transitioned to the video to watch the innovations discussed by Scott, please forward to 38:00  

Exciting News for Interventional Endoscopy Enthusiasts!  In my latest episode of "The Interventional Endoscopist" podcast, I delve into the rapidly evolving world of interventional endoscopy and its expanding opportunities within ambulatory surgical centers (ASCs). Previously, we explored the performance of endoscopic ultrasound (EUS) in ASCs. Now, I'm thrilled to share insights on a groundbreaking development: the FDA's recent approval of Endo Sound technology. I had the unique opportunity to trial this innovative tool a few weeks ago, and I can't wait to discuss its potential impact on our field. Tune in to hear my thoughts and join the conversation about how Endo Sound could revolutionize interventional endoscopy practices in ASCs.   https://www.endosound.com/   Listen now and stay at the forefront of endoscopic advancements!  

In this riveting episode of "The Interventional Endoscopist," we had the privilege to sit down with Dr. Austin Chiang, the Chief Medical Officer of Medtronic GI. Dr. Chiang shared his inspiring journey from academia to becoming the CMO, providing valuable insights into his journey. We also delved into his literary contribution, as he shared the impetus and process behind his book - a must-hear for all budding authors in the medical field. Harnessing the power of social media in the medical landscape, Dr. Chiang discussed its impact and influence on his career and the broader healthcare industry. Our conversation also explored the realm of Artificial Intelligence (AI). Dr. Chiang shared his views on the current state of AI in healthcare, its potential, and the direction he believes it's heading. Lastly, we gave Dr. Chiang the floor to chat about topics close to his heart, resulting in a fascinating dialogue you won't want to miss. Tune in for an enlightening and engaging conversation filled with wisdom, experiences, and forward-thinking perspectives.     Links: https://www.austinchiang.com/ https://www.austinchiang.com/gut-book

Welcome to another episode where we dive deep into the fascinating world of Interventional Endoscopy. This time, I have the privilege of interviewing Dr. Amandeep K. Shergill, a renowned figure in the field of Gastroenterology. As the Chief of GI at the Veterans Affairs Medical Center in San Francisco and a professor of medicine at the University of California, San Francisco (UCSF), Dr. Shergill has made significant contributions to the field of medicine and in this episode, we delve into her pioneering work on ergonomics in endoscopy. Dr. Shergill shares her insights on the importance of ergonomics in improving physician comfort, and overall avoidance of injury. She also discusses the challenges faced in this evolving field and her vision for the future of endoscopy.   Join us for this engaging conversation that promises to broadens your understanding of ergonomics whether you're an endoscopist (or an aspiring one), a medical student, or just someone interested in the progress of medical science. Make sure to tune in and discover the trailblazing work of Dr. Shergill, a true innovator changing the face of endoscopy.   For more resources about ergonomics in endoscopy please refer to these links: https://www.asge.org/docs/default-source/guidelines/asge-guideline-on-the-role-of-ergonomics-summary.pdf?sfvrsn=702fe5c_1 https://www.asge.org/home/resources/publications/practical-solutions/practical-solutions-october-ergonomics-for-endoscopy-team https://www.giejournal.org/action/showPdf?pii=S0016-5107%2823%2902578-6

Welcome to the latest installment of "The Interventional Endoscopist," where we delve into the practical application of the Endorotor device, a novel innovation transforming the landscape of tissue resection. In this episode, I share my personal experiences with Endorotor, discussing its integration into my practice and its current applications. Whether you're an established professional seeking to stay informed on the latest advancements, or a curious individual eager to gain insight into the future of medicine, this podcast offers a wealth of information. Join us as we uncover the intricacies of the Endorotor device, its role in modern healthcare, and its potential for shaping the medical practices of tomorrow.       Important Links:  Academic Links: Hollerbach S, Wellmann A, Meier P, Ryan J, Franco R, Koehler P. The EndoRotor(®): endoscopic mucosal resection system for non-thermal and rapid removal of esophageal, gastric, and colonic lesions: initial experience in live animals. Endosc Int Open. 2016 Apr;4(4):E475-9. doi: 10.1055/s-0042-105207. Epub 2016 Mar 30. PMID: 27092332; PMCID: PMC4831928. Surkunalingam N, Das A, Khosravi F, Sachdev M. Sigmoid colon polyp EMR with novel endoscopic morcellator. VideoGIE. 2018 May 29;3(6):191-192. doi: 10.1016/j.vgie.2018.04.006. PMID: 30128384; PMCID: PMC6098755. Vyas N, Sachdev M, Das A, Khosravi F. Pancreatic necrosectomy using an automated mechanical endoscopic tissue extraction device. VideoGIE. 2018 Sep 25;3(11):354-355. doi: 10.1016/j.vgie.2018.08.005. PMID: 30402583; PMCID: PMC6206328. Rizzatti G, Rimbas M, Impagnatiello M, Gasbarrini A, Costamagna G, Larghi A. Endorotor-Based Endoscopic Necrosectomy as a Rescue or Primary Treatment of Complicated Walled-off Pancreatic Necrosis. A Case Series. J Gastrointestin Liver Dis. 2020 Oct 27;29(4):681-684. doi: 10.15403/jgld-2534. PMID: 33118541. Bazarbashi AN, Ge PS, de Moura DTH, Thompson CC. A novel endoscopic morcellator device to facilitate direct necrosectomy of solid walled-off necrosis. Endoscopy. 2019 Dec;51(12):E396-E397. doi: 10.1055/a-0956-6605. Epub 2019 Jul 24. PMID: 31340385. Other Links https://www.interscopemed.com/ https://mtendoscopy.com/products/gastroenterology/resection-retrieval/emr-esd/endorotor-epr/  

Welcome to Episode 18 of the "Interventional Endoscopist Podcast". In this latest installment, we explore the intriguing realm of Endohepatology, with a special focus on a newer procedure for evaluating liver disease. EUS guided Portal Pressure Measurements or also known as EUS-PPG. This episode provides an exhaustive understanding of portal pressure measurements, tracing its progression and highlighting its importance for Interventional Endoscopists. Whether you're a regular listener or tuning in for the first time, we invite you to immerse yourself in this enlightening episode. We are confident that it will resonate with you, offering invaluable insights into the dynamic field of interventional endoscopy. If our discussions spark your curiosity and engage your intellect, please subscribe. Your time and support are greatly valued. Join us on this captivating journey of knowledge and innovation in the world of interventional endoscopy!

Join us for an illuminating episode as we sit down with Dr. Amin, the System-wide Director of Endoscopy and Advanced Endoscopy at the University of Miami. Dr. Amin's expertise extends to pioneering advancements in improving clinical outcomes for pancreatic cancer and spearheading specialized practices for POEM/g-POEM procedures. In this episode, we delve into Dr. Amin's background, his career trajectory, and the evolution of his innovative program. Additionally, we uncover his invaluable insights into training pathways for aspiring interventional endoscopists, with a special focus on the development of interventional fellows. Tune in to gain firsthand knowledge and insights from a leader at the forefront of advanced endoscopy!

Join me in a captivating conversation with Dr. Neil Sharma, a luminary in Interventional Endoscopy. Former President of Parkview Cancer Institute, Dr. Sharma shares insights into his journey, from childhood influences to pioneering Endoscopic Oncology.  Listen to the full episode wherever you prefer to get your Podcasts Connect with us on @sachdevmd on twitter and youtube Have feedback or suggestions? comment below Don't miss out on future episodes! Subscribe to The Interventional Endoscopist and stay tuned for insightful conversations with industry experts.

If you are a fellow and are looking for a job, this helps give you the basics about the types of jobs available. Some of the things are based off my experience and opinions. This is also great for people who are lookng to change jobs.   I mention Doximity's career finder and here is a link: https://www.doximity.com/careers

Dr. Advani is a passionate Interventional Endoscopist who specializes in Endobariatrics and has a passion for mentoring young physicians. She is involved in the several Societies and is a rising star in the field. I had the pleasure of interviewing her for the podcast

Liver Biopsy is slowly getting back in the GI world, primarily due to EUS guided techniques. In this episode of the Interventional Endoscopist, I share my thoughts and opinions on it, as well as a bit of my experience.  

AI has made remarkable advancements in gastroenterology. We'll discuss the notable advancements in endoscopy, and why these technologies are vital for the future of gastroenterology.

Congratulations to those of you who matched! This is obviously an exciting time. To those who didn't don't sweat it, everything works out. In this special episodes I share some thoughts about how to get ready for your 4th year

Dr. Pannala is a Professor of Medicine at the Mayo Clinic in Arizona, and a leader in bariatric endoscopy and interventional endoscopy. I had the opportunity to sit with him and discuss these topics as well as his background. 

If you are a GI fellow (third or 4th year) and are starting to look for a job, this podcast will be helpful

Dr. Raju is a noted teacher and endoscopist. He has worked tirelessly over the last 8 years to create an academic course for Endoscopy Technicians. In this podcast, we learn about him and the evolution of this course. With the help of ASGE, there is a certification expected later this year that technicians can obtain.   This will also be published on YouTube at www.youtube.com/sachdevmd   Thank you Dr. Raju for your time.   

If you are a graduating interventional (or IBD/Transplant/General fellow) this pod will give some food for thought. 

Applying can be arduous and stressful. I give you insight from a former applicant (me) as well as a program director (also me)

The title says it all

In this episode I interview an up-and-coming therapeutic endoscopist. Video available on youtube

We started an Intentional Fellowship in private practice. Some insights into it

In this episode, I explore bringing EUS to your ASC

  Links to some of the devices discussed: Black Magic:  Virgo Video