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Thank-you for posting this!!! i Am excited to read when I have time
Glad to see things are progressing. I didn't see anything about treating the problems associated with the j-pouch, though.
the article is more about how dr Shen approaches problem solving. jan
Yeah, it seems like he is still very invested. I liked that he preferred the less invasive approach, though I didn't like the analogy. People should never be discouraged from biking if we want a better world!
This is nothing more than a marketing technique, a way to get business for advanced endoscopists. And steer patients away from unnecessary surgeries they may be getting sold on by colorectal surgeons. Nothing Dr. Shen describes in that article is new, other than the term he is using for it. Excising polyps and dilating strictures have been treatments that are NOT new developments. What has changed is that GIs routinely did these procedures and many still want to- or else have referred their patients to a surgeon. Now, however, advanced endoscopists are doing these procedures more and more at major hospitals. As Dr. Shen mentions, they are a less invasive approach and possibly avoid needless surgeries and needless excision of bowel.
When my inlet stricture had to be dilated in 2021 my GI doctor, who is a veteran now in his 70s, said that he could do it. However, he told me that there was a young advanced endoscopist at Yale who was very good, and he could also do it. I then asked him how many balloon dilations he had done on inlet strictures. He said "about 5." Now keep In mind he has a fair number of J pouch patients. Most GIs have few or none. So if you have a 7 mm stricture who do you go with, the guy with 5 procedures done or the guy who does it every day?
Now Dr. Shen probably has done more than 5 balloon dilations because he is himself a J Pouch Specialist. But he isn't really telling us anything new. I think he is marketing for NY Presbyterian/Columbia, himself, and an advanced endoscopist he probably works with for the very difficult dilations. And educating patients on what is out there in terms of treatments. It may be that his patients are going to surgeons unnecessarily, or he is aware of J Pouch patients with dilation situations going elsewhere for unnecessary surgeries. And he may want to provide a less invasive approach and educate on alternatives - while also marketing for his hospital and creating business opportunities for him and his Advanced Endoscopist. There is a ton of money made on these procedures and never lose sight of that fact in reading seemingly educational materials.