Conference Program

Stephen A. Glazer, MD, FRCP(C), FCCP
Internal Medicine
Critical Care Medicine
Diplomate of the American Board of Obesity Medicine

Medical Director, Bariatric Surgical Program
Humber River Regional Hospital
American College of Surgeons Level 1 Accredited Bariatric Center of Excellence

Medical Director, Greater Toronto Area Medical Bariatric Program
Humber River Regional Hospital/University Health Network

Assistant Professor, Department of Medicine
Division of Endocrinology and Metabolism
Queen's University

Lecturer, Department of Internal Medicine
University of Toronto
Toronto, Ontario

Dr. Stephen Glazer is a board certified specialist from the University of Toronto in Internal Medicine and Intensive Care Medicine. He is also a Diplomate of the American Board of Obesity Medicine. In April 2010 he was appointed as the Medical Director for the Bariatric Surgical Program at Humber River Regional Hospital. He was instrumental in redeveloping their comprehensive bariatric surgical program. In that year, the bariatric surgical program was nominated as a Leading Practice by Accreditation Canada. In 2012 Dr. Glazer was appointed as a the Director of the only hospital-based Medical Bariatric Program for the Greater Toronto Area, which has enjoyed great growth and development due to the significant contributions of its multidiscipline team members. Dr. Glazer's commitment to the Obesity Epidemic is further displayed by his participation in many committees through the Ontario Bariatric Network and the Canadian Association of Bariatric Physicians and Surgeons. He has a strong interest in program development, quality care initiatives, and physician education. He has personally been involved in direct patient care of over thousands of bariatric patients in the attempt to facilitate weight loss for improved overall health. His research interests include perioperative risk assessment and management as well as sleep apnea in the morbidly obese. He is also the president of the Canadian Association of Bariatric Physicians and Surgeons.

Radu Pescarus, MD, FRCSC
Associate Professor
Foregut and Bariatric Surgery
Division of General Surgery
Hôpital du Sacré-Coeur de Montréal
Université de Montréal
Montréal, QC

Dr Radu Pescarus is an Associate Professor of Surgery at Université de Montréal. He specializes in minimally invasive bariatric and foregut surgery, as well as therapeutic endoscopy. After completing a Bachelor of Science in Biology at McGill University, Dr. Pescarus continued his medical studies at the Université de Montréal. Once his General Surgery residency was finalized in 2012, he continued his subspecialty training in Canada with a one-year fellowship in bariatric and minimally invasive surgery at McMaster University. Subsequently, he underwent a second fellowship in Portland, USA to further his knowledge in the fields of foregut surgery and therapeutic endoscopy. He is currently Associate Professor at Université de Montréal and performs his clinical duties in the CIUSSS du Nord-de-l’Île-de-Montréal. 

Presentation Overview

As the popularity of the laparoscopic sleeve gastrectomy (LSG) is increasing worldwide, complications such as sleeve stenosis are encountered more frequently. Dilatation with achalasia balloons is currently considered the first endoscopic therapy; however, failure to endoscopic dilatation treatment is seen in at least 25% of patients. Recently, using the same concepts as per esophageal POEM for achalasia, an endoscopic gastric myotomy (G-POEM) has been described as an option for patients with sleeve stenosis. This video will demonstrate how an esophago-gastric per-oral endoscopic myotomy (EG-POEM) can relieve obstructive symptoms in a complex case of pseudo-achalasia secondary to sleeve stenosis post LSG. 

Learning Objectives

At the end of the presentation, participants should be able to:

• Understand the different types of sleeve stenosis post LSG
• Describe the various endoscopic and surgical treatment options in post LSG gastric stenosis
• Identify which patients might benefit from G-POEM