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Creation of a third space endoscopy program at a tertiary academic US medical center

Gastroenterology & Hepatology: Open Access
Brianna Shinn, Alexander Schlachterman

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Third space endoscopy (TSE) is a rapidly evolving and advancing area in the field of gastroenterology allowing for new minimally invasive treatment options for various gastrointestinal diseases including achalasia, refractory gastroparesis, subepithelial tumors and esophageal strictures. Given the positive impact TSE can have on patients as well as the healthcare system with potentially fewer complications and long-term cost savings, more TSE training opportunities and endoscopy programs are needed. In this article, we discuss the different aspects of third space endoscopy training as well as steps and considerations that need to be addressed prior to starting a TSE program. Our hope is that an overview of our experiences creating a TSE program at our own institution, including both our successes as well as the difficulties we faced, will help inspire and guide others in the future.


TSE, third space endoscopy, ERCP, endoscopic retrograde cholangiopancreatectomy, EMR, endoscopic mucosal resection, ESD, endoscopic submucosal dissection, AMA, american medical association, CMS, centers for medicare and medicaid, ASGE, american society for gastroenterology endoscopy, CPT, current procedural terminology, RUC, relative value scale update committee