Neil Sharma, M.D. FASGE, FACG, AGAF @neilRsharmaMD Twitter profile

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

8 months

LAMS have the right shape for select strictures (pyloric, etc). Backload a LAMS stent for easier deployment across an enteral stricture Line it up, fold it, pull into channel Locate stricture and use “push” to deploy. #GITwitter #Endoscopy #MedEd #SoMe4Surgery #medicine

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Celebrating anniversary of multi-d foregut program we established & having personally done over 100 POEM over the last 18 months or so POEM tips & tricks voL 1 Use, share, learn - happy to connect with others around designing a program, proctoring etc #GITwitter #esophagus

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

“Classics in endoscopy” series Station 1 EUS. Some 🔑 points: 1- trace aorta and find first vessel (celiac) then next (sma) 2 follow celiac as it splits, see splint artery to find body/tail pancreas 3- even without very altered anatomy knowing the vessels helps you get oriented

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Can we predict post ERCP pancreatitis by amylase & lipase levels? I was fascinated working with @HemantGoyalMD @SChandanMD @AbhilashPerise1 & the group on this question. 🔑: lipase level < 3 x ULN within 2 to 4 hours of ERCP open access publication:

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

10 months

?Paradigm changer FDA approves device for EUS Guided gallbladder drainage 🔥🔥 A major milestone for field of intervetional Endsocopy & new minimally invasive options for patients Link to our prospective FDA trial here: #Medicine #GITwitter #Endoscopy

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Classics in Endsocopy series: Ulcerated nodule on endoscopy.. wide differential including #GIST & #neuroendocrine tumor (NET) .. EUS can help diagnosis, stage & tx plan. This is growing from layer 3 - submucosa meaning non-muscular origin Bx proven NET T1N0 #oncology #GITwitter

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139

Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Classics in endoscopy series EUS station 4: D1, D2, D3 The classic “snake eyes”, Kiss the ampulla and rotate the scope. CBD above the PD #MedTwitter #MedEd #GITwitter #endoscopy #eus #gi #surgery #Endoscopy

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

Like this picture to help others visualize an overview of the variety of endoscopic resections The space of resection & indications continues to expand along with the tools and expertise #meded #endoscopy #endoscopicsurgery #gastroenterology #innovation #oncology

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

“Classics in endoscopy” series; Views of the head of the pancreas from the duodenal bulb. First shown w radial Eus and called “stack sign” seeing common bile duct, panc duct and portal vein in one view - good image of pancreatic head. #eus #pancreas #endoscopy #meded #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Endoscopic full thickness resection using hybrid knife and suturing For scarred adenoma that does not lift. Lesion too big for FTRD device Essentially a “freehand”TAMIS. Negative margins. No carcinoma invasion. No open incisions. Quick recovery. #innovation #GITwitter #endoscopy

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122

Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

EUS Core liver biopsy >3 cm core Data supports: ✅wet suction rather than slow pull ✅Heparinized needle ✅3 rather than 1 actuation ✅use stylet to keep specimen intact ✅19 rather than 22 ✅FNB needle rather than FNA #Hepatology #Liver #Endoscopy #MedEd #GITwitter

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118

Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Achalasia cases today.. POEM (Per oral endoscopic myotomy) anatomy landmarks during myotomy. Note how thick the circular muscle layer becomes. @AllonKahn @EndoscopyOthman #esophagus #meded #medtwitter #gitwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Pig model when we tested settings for ERBE Vio 3. PreciseSECT setting Use electrosurgery principles to your advantage: ➡️side of blade to increase surface area ➡️go slowly through the vessel for coag effect (algorithm will do the work) Say bye to coagrasper 😉 #Meded #endoscopy

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108

Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

In honor of #colorectalcancerawareness & #ColorectalCancerAwarenessMonth Highly fibrosed lesion Prior polypectomy Prior tattoo on the adenoma ESD: 1hr 4min En bloc - curative resection Tubular adenoma with focal HGD Outpatient #Colonoscopy can stop #cancer #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

“The most beautiful part about any craft is starting at the beginning. That is the most purest form of artistry bc you have to learn the building blocks. Every little step. The championship are a byproduct of those things.” -Kobe Bryant Applies to the fundamentals of EMR to ESD

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Day 1 with our new interventional #endoscopy fellow @thayern Case 1 - EDGE on roux-en-y w ercp Case 2 - mediastinal EUS Case 3 - pancreas Eus/ercp Case 4 - rfa esophagus On and on.. welcome brother #mentorship #service to patients, research, science, commitment ✊🏽

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

First use in the United States of a novel ESD knife - the ProdGI multifunctional knife 🔪.. moved a from insulated tip to forward cutting. We found it to be very useful in complex cases changing resection approach in real time. #innovation #endoscopy #GITwitter @EndoscopyNow

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

Diagnosis and Management of Pancreatic Cysts: A Comprehensive Review of the Literature Open access to our publication here 👇 @som_krishna @HariGopakumarMD #GITwitter #pancreas #cancer

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Classics in endoscopy: <2cm pancreatic mass - adenocarcinoma. Good to see CT vs EUS vs MRI imaging of the same lesion. Being able to reconstruct 3D vs 2D mentally helps grow EUS skills and expand your ability to perform interventions outside gi tract. #eus #gitwitter #meded #gi

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Hot off the press 🔥 Using glucagon w ERCP? Glucagon in ERCP published in EIO: ➡️less post op ERCP SAE with use ➡️no significant hyperglycemia Honored to mentor rising ⭐️s our advanced endoscopy fellow @AbhilashPerise1 & @HemantGoyalMD 👏👏 #MedEdChat

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Stops signs at end of POEM tunnel: Spindle veins, large vessels - sometimes coming off gastric artery & reorganization of muscle layer which is the cardia of the stomach for posterior approach. #MedEd #endoscopy #some4surgery Tips & tricks:

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

10 months

#GIfellows this is one of the lesions to avoid putting a needle in on EUS On endoscopy it presented at subepethelial lesion with normal mucosa in Esophagus This is a duplication cyst #MedEd #Endoscopy #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Endoscopic J tube (failure to thrive, post Esopahgectomy patient). In altered anatomy these can be placed safely, endoscopically, minimally invasive. #MedEd #esopahgealcancer #nutrition #endoscopy #gitwitter #cancer #surgery

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Honor to match a top choice candidate for 2023 interventional endoscopy! Ricardo Marrero-Torres - San Juan, 🇵🇷 His goal of returning to PR & providing enhanced/novel services, ongoing research, academic career & services to his community truly moved me 🙏 #latinos #GItwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Going to start posting up some day to day “classic findings.” When are you performing a #eus for dilated bile duct or abnormal liver function test and you see this you have to just smile 😊 stone in the bile duct with acoustic shadowing. Time for #ERCP . #MedEd #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Tip 1- important for all endoscopists to understand pathology classification of Haggits score. We need to know endoscopic and pathology classifications. See picture and link to a nice review article.

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

“Classic endoscopy series” Duodenal lesion ..1st step: endoscopic evaluation. Start with basics: what segment of duodenum, location relative to ampulla, %circumference/size, Paris classification, pit pattern, look for ?warnings signs of deep invasion. Can you name these? resect?

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Now you see it, Now you don’t. Endoscopic suturing of large ESD defect. The ability to perform full thickness suturing open doors .. & allows for minimally invasive salvage therapies as well as closure of post resection defects. 2-0 polypropylene running mattress used here

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

Our EUS guided GB drainage prospective trial acute cholecystitis for poor surgical candidates in Annals of surgery🔥👇 Growing body of literature for this indication #GITwitter #MedEd #SoMe4Surgery @ChahalPrabhleen @MSawhneyMD @EndoTx @DrLakhtakia

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

7 months

Paclitaxel Nanopac - a large surface area nano particulate that creates a biome within the pancreatic #cancer after EUS guided injection for goal to shrink for R0 resection We took the trial from phase 1 to phase 2 #surgery #GITwitter #oncology #CancerResearch #Cancer #medicine

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

27 days

Last months with my Interventional endoscopy fellow @RicardoJJMK I always wonder if I did a good enough job? ➡️ercp ➡️EUS In chest / abdomen + TX ➡️suturing ➡️EMR / Endoluminal ➡️develop leadership and confidence Life long relationship ✔️ He will be back in #PuertoRico

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Kudo, NICE, Paris classification all play a role in evaluation prior to endoscopic resection. Learn about that and more on @EndoscopyNow part 1 advances in endoscopic resection - EMR to ESD Tomorrow 7pm eastern Register free #GITwitter #MedTwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Screen early! Colon adenoma - en bloc resection via ESD for Advanced adenoma in patient <45. Sent for genetic counseling #colonoscopy #Cancer #ASCO22 #GITwitter #MedEd @ASGEendoscopy @AmCollegeGastro @ASCO @AmerGastroAssn (As always shared w permission of patient)

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

POEM (per oral endoscopic myotomy) on a busy 3rd space day. As a treatment for achalasia, we dissect the Esopahgeal muscle & GE junction through creation of a tunnel Can you see the wall layers ? See picture and then answers #GITwitter #MedEd

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

11 months

The mentor-mentee relationship & Working together in a teaching program is truly amazing. Interventional #endoscopy fellowship Congratulations to @thayern 🎉 Carrying on our traditions as he moves forward to share his new skills w and serve patients #GITwitter #MedEd

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

What’s happening ?

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

11 months

Congratulations to our new Advanced #Endoscopy fellow Ricardo Marrero-Torres Representing #puertorico week 1- multiple spyglass, ercp, lots of EUS, esophageal sent, colon emr hands-on! Also participated in EUS gb and cystgastrostomy Hard work, bright future 🌟 #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

With increase of #endoscopy in the US, interventional & #gioncology specialties get referrals for incidental #neuroendocrine tumors of duodenum. Can be scary for patients but important to stage & review & counsel on limited Risks & options with 1 cm and less. #cancer #oncology

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

EUS guided trangastric paracentesis and EUS guided peritoneal metastasis biopsy when found unexpectedly during cancer workup allows for comprehensive staging, improves expedited workup, and can reduce cost #Cancer #oncology #GITwitter #endoscopy #Meded

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

(1/3) Gallbladder polyp - seen on EUS + abdominal US Keys 🔑 to know for your patients: ➡️ 4% to 7% of adults may develop gallbladder polyps. ➡️ @ 5% of these are the kind that could potentially turn into cancer. #MedEd #GITwitter #gallbladder #medicine

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

My attending’s view of the advanced fellow doing an Axios for pseudocyst after doing pancreatoscopy for MD ipmn, #ercp lithotripsy, Axios stent removal, colon emr and diagnostic #EUS already this AM Mentoring Sponsoring Pride in those who will carry care for our patients forward

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

POEM - per oral endoscopic myotomy. View form in the submucosa tunnel: Good to understand the anatomy. #Endoscopy #Achalasia #GITwitter #MedEd #Gifellows

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

VIO 3 & hybrid knife have made my use of coagrapers for POEM obsolete. #electrosurgery waveforms on this machine are ⭐️ -skeletonize 1st to expose -use side of shaft -go slow on preciseSECT setting as you come through the vessel #meded #endoscopy #gitwitter #SoMe #innovation

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

🔥🔥🔥 Invite all to 👀 for a new journal in the GIE family from @ASGEendoscopy & @ElsevierConnect iGIE - novel perspectives, innovations & ideas Led by @MetabolicEndo & 🌟editors - the future is here #gitwitter #endoscopy Clip from 1st podcast:

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

In honor of gi #asco @ASCO @AmerGastroAssn Patient saw myself and the amazing @UzmaSiddiquiMD and our multi-d teams Bx- adenocarcinoma EUS: T1, N0 No nodes or met on PET or CT ?esophagectomy or ESD We - the patient & multi-d teams - chose ESD. Path: T1a, negative margins

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

1/2 Ultra short segment Barrets - was on surveillance - sent to me for 2nd opinion staging and possible treatment by ESD -Mod diff adenocarcinoma of esophagus/GE junction on bx -Normal CT chest. 👀 at subtlety of endoscopic view (early mass noted) and impact of EUS #oncology

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Duodenal EMR -Highest risk location for complications -Need to know location relative to ampulla 1- cold or hot ? 2- what electrosurgery settings do you use 3- thermal ablation of edges ? 4- closure? *case of sporadic adenoma attached #GITwitter #endoscopy #MedEd #gi

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

All current, incoming and applying interventional #endoscopy #fellows - this is a must attend event for DDW !!! Connect with your specialty Save the date. The committees will soon be soliciting video presentations on the 8 categories #gitwitter #GItwitter #MedEd #GIfellows

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

EUS image of Side branch IPMN Note the subtle side branch connection!! All markers lined up w BD-IPMN in this case ✅Molecular markers + for KRAS & GNAS ✅glucose ⬇️ low ✅mucin positive (see thick clear aspirate) #GITwitter #Pancreas #Endoscopy #MedEd @som_krishna #Eus

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Power of EUS for locoregional staging of Esopahgeal cancer. We load EUS images to PACS to review at tumor board by multi-d team along w ct/mri/PET. T4b Esopahgeal cancer abuts aorta w at least focal margin adventitia compromise #asco #oncology #eus #gi #cancer #MedEd #MedTwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

Locally advanced pancreatic cancer with obstructive jaundice bili>5 in the era of neoadjuvant approach for pancreatic #cancer what’s you / your centers preferred choice of biliary drainage? -plastic stent -covered metal stent -other ? #GITwitter #oncology #surgonc

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Longer common channel seen in roux- en-y #ERCP after removal of metal stent. Good to know differences & definitions vs: -Anomalous PB junction (>15mm) -choledochal cyst

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Novel treatments = novel problems Complex case >1 year out from EUS guided gastric varices coiling. Small coil seen on video on limited residual gastric varix. What would you do next? #endovascular #endohepatology #EUS therapeutics #endoscopy

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Spindle veins! The sign that you are at the GE junction when operating in 3rd space for POEM or seen with ESD for GEJ carcinomas and other lesions. Keep a look out for this landmark. #Endoscopy #ESD #endosurgery

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Complex ESD. Hemicircumferential adenoma. BX by referring showing HGD Tubullovillous adenoma: approach- en bloc resection without full thickness to see sm for diagnostic and curative intent.. Patient home same day. Asymptomatic with negative margins and no SM involvement

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

The “classic findings�� Eus series. What does pneumonbilia look like on EUS?? Bright white flecks, some times shadowing. Here you can see the level of detail Eus provides in the liver. Worth seeing CT correlate to get an appreciation of both for learning. #eus #meded #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

FITE - Foundation for Interventional Endoscopy This group of all ⭐️leaders !! The energy, the vision.. creating universal standards for training and proficiency, a platform for research/innovation & marching towards a nationally recognized subspecialty #endoscopy #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Hemi-circumferential #esd for #esophagealcancer at GEJ. T1a. Stricture rates are less than circumferential. Less 💰, less morbidity for patients #nccn #gioncology #meded #GI #oncology @ASGEendoscopy @ASCO @AmerGastroAssn @ecancer

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

What NOT to do - tattoo placed right on an adenoma sent for EMR. Here is post resection. SM has tattoo .. great job by our advanced fellow @thayern who is getting quite good at handling these !! Tattoo is preferred on opposite wall or at least 3 cm away #GITwitter #MedEd

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

ESD in stage 1 esophageal cancer. Curative ESD for resection of a proximal Esopahgeal T1a squamous cell carcinoma who has a clip in situ from a prior post biopsy bleed when referred. We were kept dissection at SM3. #endoscopy #esd #gitwitter #oncology #cancer ⁦⁩

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Hemi- circumferential ESD For early Esopahgeal #cancer Is a viable alternative to Esopahgectomy per NCCN guidelines for T1a Esopahgeal cancer Multi-D approach Organ sparing surgery Patients should be aware #CancerAwareness #cancersurvivor #Meded #GITwitter #oncology

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

2nd session of Ablation with EUS rfa probe of neuroendocrine panc tumor. Reduced from 2cm after 1 treatment. Refused surgery. We 1st showed our data in 2015. Using different probe on this trial. Likely has a role <2cm pnet. Some good data by @DrLakhtakia . Need more studies

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Acute on chronic #pancreatitis w multiple pseudocysts. External drains placed & referred for ongoing drainage. Placed and upsized to 10fr. Drain out put resolved. Patient doing great. >80% efficacy of PD stents for PD leak in pancreatitis. Nice review:

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Bilateral stents for nonresectable cholangiocarcinoma & s/p rfa monotherapy (refused chemo) 3yrs out, stable Lots of ❓ to be guided by data & more studies underway: ➡️bilateral vs unilateral stent in era of immunotherapy ➡️value of ERCP RFA - more than just plumbing (immune?)

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

Biliary obstruction from #pancreas #cancer can be treated with creation of bypass via EUS for select candidates. Outpatient procedure resume chemotherapy asap See this short video for details #endsocopy #oncology #gifellows #GItwitter #pancreaticcancer

Biliary Bypass copy.mp4

Shared with Dropbox

www.dropbox.com

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Advanced Endoscopy Fellowship training. “Walk me @through EUS liver vasculature” @AbhilashPerise1 Help others continue to build on their foundation & keep 🧗‍♂️ climbing to another level. Support, invest, push, listen, admire. #MedEd #Liver #EUS #mentorship #future #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Post myotomy endoflip in patients undergoing POEM. I assume others are doing this universally before and after. In addition to other techniques. I found myself extending the myotomy on 2 occasions over the past few months prior to closing the tunnel. Personalized #medicine #gi

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

Before and after - En bloc ESD w video of post resection scar bed for T1 Adenocarcinoma arising from Barrett’s with multi focal dysplasia NCCN supported, Organ sparing option Eso #cancer awareness month #MedEd #Endoscopy #GITwitter #Esophagealcancer #Oncology #Cancer

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

Pay it forward … Generations of interventional endoscopy fellows & now attendings I have had the honor of mentoring I’m so blessed to have an opportunity to be part of this sisterhood/brotherhood. Research, teaching, program building, patient care.. we are one #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 year

Video from @GIE_Journal Top Tips Zenkers Diverticulotomy publication Watch YouTube link: #endoscopy #GITwitter #MedEd #surgery

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Classics in Endsocopy - radial view of the mediastinum (hopefully it’s not a dying art). Can you name structures? Some tips: 1- orient spine to 6 o’clock 2- Aorta to 4-5 o’clock 3- correlate structures on Eus to centimeters from the incisors #eus #ebus #chest #SoMe #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

1/ Practice of fundamentals: How do you describe this #EUS lesion: 1- Well vs poorly circumscribed 2- hyper/iso/hypo/an - echoic 3- size 4- relationship to other key structures 5- location #MedEd #radiology #Endotwitter #endoscopy #GItwitter #AEF

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Classics in endoscopy series; EUS is the best modality for high res view of wall of abdominal viscera. Know wall layers on EUS as they determine differential diagnosis. Layer 2 & 4 are muscle: So leimyoma, GIST etc #oncology #cancer #gitwitter #gi #surgery #Meded #radiology

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

🔥off the press. Our article on use of AI in pancreaticobiliary/ cancer related endoscopy - adding to a body of work. AI is one 🔑 tech to 👀 Congratulations to @HemantGoyalMD @AbhilashPerise1 @bentharian & the amazing research team. #MedTwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

If you get the Cholangiogram after cholecystectomy .. patient with pain out of proportion Mirra se puede ver la fuga?? 👀

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

After

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Honored to so a plenary oral report on our phase II getting R0 resection after locally advanced Eus guided nanoparticle injection for locally advanced pancreatic cancer at @AmCollegeGastro ! Multi-D treatment for cancer care can change the future. @ASCO

EUS guided injection for treatment of pancreatic cancer with NanoPac

Clinical Trial - EUS guided tumor injection with Nanopac for the treatment of Pancreatic Cancer

www.youtube.com

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

“Classic images in endoscopy series”: Weight loss, vague abdominal pain, Normal labs now. Normal standard CT 2 months back. EUS shows abrupt ductal dilation behind a small T1 mass. Always trace a dilated duct & 👀 for change #endoscopy #eus #gi #pancreas #oncology #gitwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

GASTRIC GIST - downsized by neoadjuvant approach and resected by STER (submucosal tunnelling endoscopic resection). No open incision. Shrunk from >3cm. Multi-d approach by my gi med Onc partner @realbowtiedoc . Appreciate the Innovation. #gioncology #endoscopy #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

April is Esopahgeal Cancer awareness month 👉 During the 1960-70s, only about 5% of patients survived at least 5 years after being diagnosed. Now, 19-20% of patients survive at least 5 years after diagnosis 👉20-21k new cases this year in USA, >16k deaths Facts all month! Share!

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Pod 3 from cholecystectomy patient comes to ER with abdominal pain, abdominal echymosis, normal lfts, and wbc 13. Afebrile. Some imaging performed. Ercp Cholangiogram shows this: what do you see? What’s the treatment ? #medtwitter #MedEd #GITwitter #ercp

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

#ScopingSundays "Management of Gastric Polyps" on Sunday February 20 at 2 PM EST Proud to be joining @BalissMichelle & @NumanLaith Learn concepts like -endoscopic recognition of the lesion -type of gastric polyps -what to bx and what to EUS -What to resect? & more #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Images in endoscopy: Patient referred after imaging finding Pancreatic cyst EUS shows below - what’s happening with this lesion??? (Answer to follow) #Meded #Medtwitter #GITwitter #eus #pancreas #oncology @asge @AmCollegeGastro @AmerGastroAssn @eus_endo @eus_endo @AGA_TIGE

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Congratulations to @AbhilashPerise1 Our partners & I in the advanced interventional #endoscopy program could not be more proud of his talent, effort, and sacrifices during this past year. Bright future ahead for this rising ⭐️ #GITwitter #MedEd #Fellowship @ASGEendoscopy

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

1 month

School is in session!! Professor Jirapinyo dropping science on the hands on lab at the WISE course!! 😊👏 Countless hands on labs done with @MetabolicEndo . Love to teach endoscopy, and help people explore new technologies and techniques. #GITwitter

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Welcome to our new advanced endoscopy fellow. @AbhilashPerise1 Day 1 -multiple cellvizio, multiple rfa. did cryoablation. did an ERCP in a diverticulum a J shaped stomach. multiple EUS & engaged in Eus core liver biopsy. Nothing greater than opening doors and mentoring!

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Often asked, Does acute pancreatitis herald pancreatic ductal adenocarcinoma? Proud to share our latest research around the question. Congrats #RiturajSingh & team! #pancreas #oncology #GITwitter @EileenMOReilly @PanCAN @apapancreas @alisonpklein

Does acute pancreatitis herald pancreatic ductal adenocarcinoma? A multicenter electronic health...

Cancer Medicine is an open access, broad-scope oncology journal covering clinical cancer research, cancer biology, cancer prevention, & bioinformatics.

onlinelibrary.wiley.com

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

2 years

Classics in endoscopy series: Take a look at another Esopahgeal nodule. Subepithelial lesion, incidental finding referred for workup. What do you see on EGD & EUS? What did FNB show? #MedEd #GITwitter #oncology #SoMe4Surgery @eus_endo @euro_eus

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Neil Sharma, M.D. FASGE, FACG, AGAF

@neilRsharmaMD

3 years

Proud to be a part of The landmark ESD study for North American experience published in Gastroenterology. @EndoscopyOthman @AmerGastroAssn @ThirdspaceEndo @gastrowala @SchlachtermanMD

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