The Interventional Endoscopist

Can complex interventional endoscopy thrive in an Ambulatory Surgical Center (ASC)? In this episode of The Interventional Endoscopist, host Dr. Mankanwal Sachdev sits down with pioneer Dr. Isaac Raijman (Associate Professor at Baylor College of Medicine) to explore the evolving landscape of outpatient therapeutic GI. Dr. Raijman shares his journey from fiber-optic endoscopes to modern digital cholangioscopy, breaking down the financial, clinical, and operational realities of transitioning EUS, ERCP, and endobariatrics out of the hospital setting. In this episode, we discuss: The Business & Economics: Navigating Medicare facility fees, disposable costs, and margins for EUS and ERCP in the ASC. Patient Selection & Safety Guardrails: Strict ASA criteria, BMI limits, equipment requirements, and complications management outside the hospital. Cholangioscopy & Stone Management: Practical takeaways from Dr. Raijman's DDW study on single-operator cholangioscopy and EHL in outpatient settings. The Future of Outpatient Intervention: What the shift toward outpatient care means for current fellows, interventional job markets, and the next frontier of interventional EUS. Whether you are a fellow preparing for practice or an attending looking to expand your ASC's therapeutic offerings, this conversation offers an essential blueprint for modern interventional GI.

In this episode of The Interventional Endoscopist, host Dr. Vinkaval Satdev sits down with Dr. Davinderbir Singh Pannu, a recognized leader in advanced therapeutic endoscopy at McLeod Health. For years, Endoscopic Submucosal Dissection (ESD) has been the gold standard for en bloc resection of complex mucosal lesions, but steep learning curves and equipment limitations have kept it centralized in major academic hubs. Dr. Pannu shares his journey of building a high-volume third-space endoscopy program (performing 80–100 cases a year) in a regional health system, saving patients from traveling hours for advanced care. Dive deep into the physics, economics, and clinical application of next-generation electrosurgical platforms. Dr. Satdev and Dr. Pannu break down the transition from traditional monopolar energy to multimodal bipolar microwave platforms—specifically focusing on the Creo Medical Chroma system with the Speedboat device. Key Takeaways: The Physics of Safety: How bipolar microwave energy limits collateral tissue damage and minimizes delayed perforations compared to traditional monopolar units. Tactile & Operational Shifts: Mastering pure cut currents, managing tissue resistance variations, and optimizing scope control. The Business Case for Advanced Tech: Navigating Value Analysis Committees (VAC), tracking downstream revenue, and proving ROI to hospital administrators. Clinical Humility & Career Growth: Dr. Pannu’s approach to mastering one major new technical skill every single year. Note: This podcast is completely independent and is not sponsored by any device company.