Third Space Endoscopy — Session 3: Tips & Tricks in Tough Cases

Overview

Session 3 of the SGA Third Space Endoscopy series — a focused, hybrid CME-accredited evening on the technical and clinical challenges that make advanced submucosal tunneling procedures so demanding. The programme opens with an international keynote from Dr. Abdullah Murat Buyruk (Ege University Faculty of Medicine, İzmir, Türkiye) — a high-volume operator of over 2,000 ESDs and more than 1,000 POEM procedures — on tips and tricks for navigating fibrosis, tunneling strategies through sclerotic planes, myotomy selection in complex achalasia and redo cases, and the timely recognition and management of intraprocedural adverse events. Two Saudi-based short talks then cover post-POEM reflux — an increasingly common downstream problem — and a differential-diagnosis reminder that not every case of gastritis referred for endoscopy is H. pylori. Designed for advanced endoscopists, therapeutic-endoscopy fellows, and gastroenterologists building a POEM / G-POEM / Z-POEM practice. Supported by Jamjoom Pharma.

Why attend this course

• Learn directly from Dr. Abdullah Murat Buyruk (Ege University, İzmir) — a high-volume third-space endoscopist with 2,000+ ESDs and 1,000+ POEMs
• Master tunneling strategies through fibrotic and previously-treated submucosal planes
• Understand myotomy selection logic in Type III achalasia, sigmoid esophagus, and post-Heller / redo POEM patients
• Build a structured response to intraprocedural adverse events — mucosotomy, capnoperitoneum, bleeding, defect closure
• Get pragmatic guidance on medical management of post-POEM reflux from a Saudi-based expert
• Sharpen your gastritis differential — the diagnoses internists forget beyond H. pylori

What you will learn

• 1Identify the anatomical and pathological factors that make third space procedures technically demanding — severe submucosal fibrosis, prior endoscopic or surgical intervention, sigmoid/end-stage esophagus, and difficult tunnel orientation
• 2Apply practical tunneling and dissection strategies to hold the correct plane, preserve orientation, and progress safely through fibrotic or scarred submucosa
• 3Select the appropriate myotomy approach and length in complex scenarios, including spastic and end-stage achalasia, redo POEM, G-POEM, and Z-POEM
• 4Recognize and manage intraprocedural adverse events — mucosal injury, bleeding, and gas-related complications — and apply effective salvage and closure techniques
• 5Integrate traction methods, device selection, and closure options to improve technical success and safety in high-risk and referral cases

Scientific program

Who should attend

• Advanced therapeutic endoscopists performing or planning to perform POEM / G-POEM / Z-POEM
• Senior gastroenterology fellows and advanced-endoscopy trainees
• General gastroenterologists managing achalasia, gastroparesis, and post-myotomy reflux patients
• Foregut surgeons collaborating on complex esophageal motility cases
• GI internists and hospitalists seeing referrals for chronic gastritis and reflux

Course format

• International keynote lecture (45 minutes) with case videos
• Two focused Saudi-based short talks (15 minutes each)
• Hybrid delivery — in-person at Kempinski Al Khobar and simultaneous webcast
• Live audience Q&A moderated by the course directors
• CME-accredited certificate of attendance