Endoscopy reports: not all created equal

Endoscopy reports: not all created equal

Medhat Fanous

Department of Surgery, Aspirus Iron River Hospital & Clinics, Iron River, MI, USA

Correspondence to: Medhat Fanous, MD, FACS. Department of Surgery, Aspirus Iron River Hospital & Clinics, 1400 W Ice Lake Road, Iron River, MI 49935, USA. Email: medhat.fanous@gmail.com.

Comment on: Mugino M, Little SC, Weerasinghe DP, et al. Lack of diagnostic efficacy of endoscopy for paraoesophageal hiatus hernia (PEH). Ann Laparosc Endosc Surg 2022;7:21.

Received: 20 June 2022; Accepted: 27 July 2022; Published: 30 October 2022.

doi: 10.21037/ales-22-33

Upper gastrointestinal endoscopy (UGE) is usually performed by gastrointestinal physicians or surgeons. The reports are usually for diagnostic purposes to guide medical management for conditions like gastritis, duodenitis or gastroesophageal reflux disease (GERD). The quality of the reports varies based on knowledge and experience.

UGE for planning purposes, such as preoperative evaluation of hiatal hernia, underscores the need for accurate formal assessment. The endoscopic antireflux modalities such as transoral incisionless fundoplication or Stretta are indicated for hiatal hernia of 2 cm or less in axial height. Lack of identifying a hiatal hernia or inaccurate measurement and reporting of its size may result in offering the wrong antireflux modality (1-3).

Endoscopic evaluation of paraesophageal hernia is usually straightforward yet, can be easily missed in inexperienced hands. The Hill’s Grade and axial height of hiatal hernia, among others, are objective findings that should be included in every endoscopic report (4). The author of this article demonstrates the variability of reporting among different endoscopists. This highlights the need to pursue the conventional wisdom of the operating surgeon performing his own endoscopy. However, this approach may not always be feasible due to various logistical reasons. The best pragmatic approach is to train and educate endoscopists to follow a standardized reporting which is reproducible.


Funding: None.


Provenance and Peer Review: This article was commissioned by the editorial office, Annals of Laparoscopic and Endoscopic Surgery. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://ales.amegroups.com/article/view/10.21037/ales-22-33/coif). The author has no conflicts of interest to declare.

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doi: 10.21037/ales-22-33
Cite this article as: Fanous M. Endoscopy reports: not all created equal. Ann Laparosc Endosc Surg 2022;7:32.

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