Precut needle-knife sphincterotomy in advanced endoscopy fellowship

Abstract

Many advanced endoscopists finish their fellowship with very little training on how to perform needle-knife sphincterotomies. It has been described as a procedure not for the faint of heart and a technique that should not be substituted for lack of experience. I recently spoke to John Goff, creator of the transpancreatic septotomy technique, and asked for his thoughts on the subject. His reply was “know your anatomy, know when to stop, know when to regroup and when to try again the next day.” In this month's Fellows' Corner, Drs Anastassiades and Saxena share with us the tips and tricks of successful mastery of the needle-knife technique during advanced fellowship.