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Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD

@Taalamri • 13,495 subscribers

طبيب استشاري|طب باطني/جهاز هضمي وكبد/مناظير متقدمه|الزمالة الكنديه-حساب شخصي |Gastroenterologist|Advance Endoscopist #ERCP#EUS#POEM#ESD @uoft @McGillu

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🔴Nice teaching case for the advanced therapeutic fellow ERCP Teaching Pearl 🧠 | Hock-Pull Technique in Supine Position 🛌 Supine patient = altered orientation → technique matters 🔹 Papilla orientation: In supine ERCP, the papilla often appears more inferior/posterior and less en face, with a tendency for the catheter to fall into the pancreatic duct due to gravity and scope torque. 🔹 Why Hock-Pull helps: • Hockey bow redirects the tip upward toward the biliary axis despite gravity. • Gentle pull-back everts and opens the papillary orifice, counteracting the “downward fall” seen in supine cases. • Improves coaxial alignment (~11 o’clock) without pushing. 🔹 Manoeuvrability advantage: • Pulling back stabilizes the papilla against respiratory motion. • Small rotations become effective—micro-adjustments instead of force. • Reduces repeated pancreatic duct entry and papillary trauma. 💡 Pearl: > “In supine ERCP, gravity favors the pancreas—hock-pull brings you back to bile.” #ERCP #SupineERCP #Endoscopy #GI #TeachingPearls #PatientSafety

🔴Nice teaching case for the advanced therapeutic fellow ERCP Teaching Pearl 🧠 | Hock-Pull Technique in Supine Position 🛌 Supine patient = altered orientation → technique matters 🔹 Papilla orientation: In supine ERCP, the papilla often appears more inferior/posterior and less en face, with a tendency for the catheter to fall into the pancreatic duct due to gravity and scope torque. 🔹 Why Hock-Pull helps: • Hockey bow redirects the tip upward toward the biliary axis despite gravity. • Gentle pull-back everts and opens the papillary orifice, counteracting the “downward fall” seen in supine cases. • Improves coaxial alignment (~11 o’clock) without pushing. 🔹 Manoeuvrability advantage: • Pulling back stabilizes the papilla against respiratory motion. • Small rotations become effective—micro-adjustments instead of force. • Reduces repeated pancreatic duct entry and papillary trauma. 💡 Pearl: > “In supine ERCP, gravity favors the pancreas—hock-pull brings you back to bile.” #ERCP #SupineERCP #Endoscopy #GI #TeachingPearls #PatientSafety

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🎯 3 Teaching Pearls from the “Compact Disc” Method for ERCP Cannulation 1️⃣ Visualize the invisible. Imagine stacked CDs inside the papilla to conceptualize the 3D bile duct axis—especially in long oral protrusion (LOP). 2️⃣ Advance gently, not forcefully. Cannulation should feel like passing through the center hole of each CD. Force bends the axis and increases injury risk. 3️⃣ Alignment is everything. Ensure scope position and catheter axis are “face to face” with the imagined duct axis before advancing. Simple concept. #ERCP #Endoscopy #MedicalEducation #AdvancedEndoscopy #Basics #KFHU #BiliaryCannulation

🎯 3 Teaching Pearls from the “Compact Disc” Method for ERCP Cannulation 1️⃣ Visualize the invisible. Imagine stacked CDs inside the papilla to conceptualize the 3D bile duct axis—especially in long oral protrusion (LOP). 2️⃣ Advance gently, not forcefully. Cannulation should feel like passing through the center hole of each CD. Force bends the axis and increases injury risk. 3️⃣ Alignment is everything. Ensure scope position and catheter axis are “face to face” with the imagined duct axis before advancing. Simple concept. #ERCP #Endoscopy #MedicalEducation #AdvancedEndoscopy #Basics #KFHU #BiliaryCannulation

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What's the tremendous progress with huge enthusiasm of my 🌟 brothers د. ابراهيم الحافظ Ibrahim Alzahrani to adopt third space endoscopy program . We Performed the first case of Peroral endoscopic myotomy ( POEM ) And Rectal ESD that definitely will be added to premium motality program with Dr.Abdulaziz Alruzuk and luminal GI Programs...Great help and support from the nursing team , Anaesthesia team and Hospital Medical Director ماجد العبدلي-Majed Alabdali. Special thanks and gratitude to our 🌟 Dr.Aymen Aymen Almuhaidb, MD with busy schedule to help and launch such special procedures . Great ERBE knife we're used to. In between both patients are doing fine post procedures. 🔴الحمدلله ؛ بفضل الله تم إجرائين طبيين فريدين من نوعهم لأول مره في مستشفى الملك فهد الجامعي بالخبر KFHU مستشفى الملك فهد الجامعي عبر أطباء الجهاز الهضمي و المناظير العلاجيه .الإجراء الأول لمريض يعاني من مرض تعذر الارتخاء ( achalasia )حيث تم إجراء بالمنظار عمل شق صغير لا يتعدى 15 مل ثم الوصول للمنطقه المستهدفة في نهاية المرئ ويتم تقطيع العضله المسببه للمشكله بينما الإجراء الثاني هي إزالة لحمية كامله من جدار الجهاز الهضمي ESD...وكلا المريضين بخير ...كل الشكر للطاقم الطبي والإداري لتسهيل مثل هذي الإجراءات ... Aymen Almuhaidb, MD . #ThirdspaceEndoscopy #Advancedtherapeutic Klaus Mönkemüller, MD, PhD Ahmad.Madkour Akwi Asombang MD MPH Ammar Kheir Antonio Facciorusso Alaa Alali Sundeep Lakhtakia Samir C. Grover, M.D. Clive Miranda, DO, MSc Jahnvi Dhar DR. MIKE FITE - Foundation Tyler Berzin MD, FASGE Justin J. Forde MD, MS, ABOM-D Antonio Mendoza Ladd MD, AGAF, FACG, FASGE J. Tabibian, FACP, FASGE, FACG, AGAF Faisal Moamen Gabr Sultan Mahmood MD FASGE Erik Holzwanger, MD, ABOM-D Prof John Leeds Bobby Jacob, MD Khaled Bamakhrama Zaheer Nabi Natalie Cosgrove MD Dr. Viswanath Reddy D Violeta Popov, MD PhD Mariam Naveed, MD Neil Bhogal, MD Douglas G. Adler MD, FASGE, FACG, AGAF

What's the tremendous progress with huge enthusiasm of my 🌟 brothers د. ابراهيم الحافظ Ibrahim Alzahrani to adopt third space endoscopy program . We Performed the first case of Peroral endoscopic myotomy ( POEM ) And Rectal ESD that definitely will be added to premium motality program with Dr.Abdulaziz Alruzuk and luminal GI Programs...Great help and support from the nursing team , Anaesthesia team and Hospital Medical Director ماجد العبدلي-Majed Alabdali. Special thanks and gratitude to our 🌟 Dr.Aymen Aymen Almuhaidb, MD with busy schedule to help and launch such special procedures . Great ERBE knife we're used to. In between both patients are doing fine post procedures. 🔴الحمدلله ؛ بفضل الله تم إجرائين طبيين فريدين من نوعهم لأول مره في مستشفى الملك فهد الجامعي بالخبر KFHU مستشفى الملك فهد الجامعي عبر أطباء الجهاز الهضمي و المناظير العلاجيه .الإجراء الأول لمريض يعاني من مرض تعذر الارتخاء ( achalasia )حيث تم إجراء بالمنظار عمل شق صغير لا يتعدى 15 مل ثم الوصول للمنطقه المستهدفة في نهاية المرئ ويتم تقطيع العضله المسببه للمشكله بينما الإجراء الثاني هي إزالة لحمية كامله من جدار الجهاز الهضمي ESD...وكلا المريضين بخير ...كل الشكر للطاقم الطبي والإداري لتسهيل مثل هذي الإجراءات ... Aymen Almuhaidb, MD . #ThirdspaceEndoscopy #Advancedtherapeutic Klaus Mönkemüller, MD, PhD Ahmad.Madkour Akwi Asombang MD MPH Ammar Kheir Antonio Facciorusso Alaa Alali Sundeep Lakhtakia Samir C. Grover, M.D. Clive Miranda, DO, MSc Jahnvi Dhar DR. MIKE FITE - Foundation Tyler Berzin MD, FASGE Justin J. Forde MD, MS, ABOM-D Antonio Mendoza Ladd MD, AGAF, FACG, FASGE J. Tabibian, FACP, FASGE, FACG, AGAF Faisal Moamen Gabr Sultan Mahmood MD FASGE Erik Holzwanger, MD, ABOM-D Prof John Leeds Bobby Jacob, MD Khaled Bamakhrama Zaheer Nabi Natalie Cosgrove MD Dr. Viswanath Reddy D Violeta Popov, MD PhD Mariam Naveed, MD Neil Bhogal, MD Douglas G. Adler MD, FASGE, FACG, AGAF

Turki AlAmri |تُرْكي عبدالله الْعَمريَّ MD

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