The World Organisation of Digestive Endoscopy (Organisation Mondiale d’Endoscopie Digestive), OMED, is a world federation of national digestive endoscopy societies. Member societies are normally affiliated to and represented by one of three geographical zones: Asian-Pacific (APSDE), European/Mediterranean (ESGE) and Inter-American (SIED). Societies falling outside these zones are regarded as independent members.

OMED, a non-profit organisation, was constituted as an international society, independent from Gastroenterology, in 1962 during the World Congress of Gastroenterology in Munich, Germany. The selected name at the time was “International Society of Endoscopy” (ISE) and this was changed to OMED on July 3, 1976.

OMED is currently composed of 97 Societies. The General Assembly, made up of representatives from these Societies, meets every four years during the World Congress and elects the Governing Council and the Committees.

Recent reports relating to sedation and analgesia during endoscopic examinations comprise have played an important part in improving the quality of the actual examination and more importantly hugely increasing the willingness of patients to undergo the procedures. Recently more and more specialists are insisting on these new sedation methods when carrying out both upper and lower GI tests and leading Health insurers like Sovereign Health Insurance with Best Doctors appear to be happy with the results thus far.

Simple Intravenous combinations of both sedatives and analgesic have been administered widely in many theatres around the world for a few years normally administered by an endoscopist or nurse assistant themselves. But in the light of recent concerns that some sedative use may itself cause complications this issue has become somewhat more controversial.

More recently a short-acting hypnotic agent, often propofol,  is used which  many patients , insurers (like Sovereign Health Insurance) and of course  endoscopists find far superior to the traditional sedation methods. Often this needs to be administered by a licensed anaesthetist but the extra benefits it brings with a more cleared diagnosis often outweighs the extra cost.

After a recent meeting of respected endoscopists they acknowledges that while the overall standards of endoscopy and sedation do of course vary  among the countries present  they do plan on setting up an internationally recognised platform relating to this new form of patient sedation  looking at more widely at Health Care NZ and well as the US , Asia and Europe.

Dr. Horst Neuhaus, Director of the Center of Excellence in Düsseldorf, Germany, demonstrates the use of a new baby cholangioscope that can be passed through a special therapeutic side viewing instrument during the recent live course in India.

Live demonstration recording from the recent live course at the Center of Excellence in Hyderabad, India under the direction of Dr. Nageshwar Reddy.

The World Organization of Digestive Endoscopy (OMED) is strongly in favour of teaching by live demonstration but believes that the safety and dignity of the patient is paramount. For this reason we have reviewed, condensed and updated the ethical advice that was published by the European Society of Gastrointestinal Endoscopy in 2003. We set out here an ethical standard for the performance of live demonstrations that was approved by the OMED Centers of Excellence and the OMED Governing Council in November 2009.

August 2009

Introduction

The past four years have been exciting, challenging and rewarding for the World Organisation of Digestive Endoscopy (OMED). The Council that was elected in 2005 recognized that radical changes were needed.  Our income in the past had depended upon the financial outcome of the World Congress and we realized that we were in difficulty owing to limited reserves and the small profit that had accrued from Montreal.

We slimmed down our Governing Council, set up an Industrial Partners’ Group and modified our statutes so that necessary changes could be adopted more quickly and flexibly.  We appointed a professional secretariat and decided to base our future activities on projects that would enable us to work more closely with our international zones, national societies and other scientific organizations.

These changes proved successful and although our immediate financial position is little changed, thanks to the generous support from our Industrial partners and to the cooperation of endoscopic colleagues throughout the world, we have completed most of what we set out to accomplish in 2005. It gives me pleasure to present this report to the OMED Governing Council and to our membership.

Education

OMED Endoscopy Directors’ Workshops (EDWs)

OMED’s mission is to promote high quality endoscopy throughout the world. One of the best ways to do this is to ensure that those responsible for the management of endoscopy have the necessary knowledge and skills to provide a safe and effective service. This was the stimulus for us to set up these workshops. EDWs are organized jointly with a national or regional society and using a combined faculty we cover the essentials of endoscopy management. The meeting is small, (40 to 80 participants) informal and interactive. We employ an interactive “voting” system to ensure that everyone can express their views. Our first workshop at the UEGW Berlin 2006 has been followed by others in Cairo (Egypt), Maceiò (Brazil), Kobe (Japan), Dubai (UAE), Delhi (India), Santiago (Chile), Brasilia (Brazil), Marrakesh (Morocco), Damascus (Syria), Taipei (Taiwan)and Salvador (Brazil). We have been delighted by their popularity and the support that we have received for them from colleagues and industry. Since we began the ASGE has implemented a similar concept within the U.S.  so we believe that we are moving along the right lines!

OMED Advanced Diagnostic Endoscopy Courses

Rapid advances in technology have provided endoscopists with sophisticated equipment that is not always used to its best advantage. Research papers and guidelines take time for acceptance so this practical initiative has been designed to teach the general endoscopist to use modern equipment and gain the most from it. The course covers recent technical advances focussing on Narrow band imaging, High definition and Fluorescence endoscopy. Courses have been held in Delhi (India), Dubai (UAE), Cairo (Egypt), and Taipei (Taiwan).

OMED Centers of Excellence

OMED recognizes the tremendous contribution that certain International centers have made to endoscopic education world-wide.  We identified seventeen departments renowned for their excellence in teaching and for providing outstanding international courses. We are grateful to the colleagues in charge of these units and those who work in them for the support that they have given to OMED not only in teaching but by contributing to meetings and workshops and assisting with our publications on clinical practice.

Clinical Practice

OMED “How I Do It” series

It is often difficult to access up-to-date practical manuals on how to perform a specific endoscopic procedure. The “How I do it” series published on the OMED web-site provides this service. Each article is written by three experts. To date we have covered: Expandable metallic stents, Removing large sessile polyps, Endoscopic mucosal resection in the esophagus, Detection of early gastric cancer, Glue treatment of gastric varices, Management of upper GI bleeding, Approach to lower GI bleeding and Placement of percutaneous feeding tubes.

The OMED Instrument Catalogue

This is published on the OMED website and provides a catalogue of endoscopic equipment  presently on sale around the globe. Products are listed in groups; for example, esophageal stents, colonoscopes or haemostatic devices. The section opens with a description of the group and their use followed by a list of what is available, their specifications and the manufacturer.

OMED Guidelines, Consensus reports and Position statements

OMED has worked closely with other organizations in holding a number of symposia and workshops that have led to the development of publications relating to clinical practice.

Guidelines on endoscope disinfection were published in conjunction with WGO in 2006. In the same year a large workshop on ethics in endoscopy and gastroenterology was held in Kos (Greece), with United European Gastroenterology Federation (UEGF) and European Society of Gastrointestinal Endoscopy (ESGE). It led to a series of publications in Endoscopy and Digestion. The Paris classification of early GI neoplasia was also published in that year and more recently a workshop in Kyoto (Japan) has produced a position statement on Non-polypoid neoplastic lesions of the colorectal mucosa.

We formed a working party with the European Crohn’s and Colitis Organization (ECCO) to write a position statement on the role of small bowel endoscopy in the management of IBD, this is now published in Endoscopy.

This year we held a workshop in Athens (Greece) with the Hellenic Society of Gastroenterology (HSG) and ESGE to produce a position statement on Sedation in endoscopy. In cooperation with the  Japan Gastroenterological Endoscopy Society (JGES) we have initiated a working party to consider guidelines on the terminology and diagnostic value of Narrow Band Imaging.

Two OMED working groups will present recommendations at Gastro 2009; one on credentialing and quality assurance, the other on the evaluation of screening tests for gastrointestinal cancer.
Three other working parties are writing a core curriculum for endoscopy training, a compendium of electronic teaching material and design of endoscopy units.

A special article by Lars Aabakken and the OMED Documentation and Standardisation Committee entitled Minimal Standard Terminology for gastrointestinal Endoscopy – MST 3.0 also appeared in the eighth issue of endoscopy, 2009.

Gastrointestinal cancer screening

The OMED upper GI cancer committee has started a multi-centre study to determine the geographic variation in the prevalence of early gastric cancer and its precursor lesions in Asia and the accuracy of endoscopic diagnosis of intestinal metaplasia and atrophy. It also hosted a Master Workshop on novel endoscopic technology and ESD with the Chinese University of Hong Kong in 2008.

The OMED colorectal cancer screening committee has run a highly successful meeting during each DDW over the past four years and has participated in a number of other International meetings over the same period. Their working party report on the evaluation of new tests for GI cancer screening is eagerly awaited at Gastro 2009.

Standardization and terminology

The minimal standards Terminology (MST) version 3 was published this year. The committee is now focusing on an online atlas of endoscopic appearances with the involvement of the OMED centers of excellence. Its next task will be to produce a standardized endoscopy report that will include the data required to provide routine quality assurance research.

OMED Research meeting reports

OMED encourages research in endoscopy as part of its mission.  A review of the abstracts presented at the three main annual GI meetings, i.e. DDW, APDW and UEGW, is published on our website following each meeting so that endoscopists all over the world are able to access the cutting edge of endoscopic research any time at no cost.

OMED Research Award

In order to encourage research, with the generosity of our industrial colleagues Takeda and Olympus we have established four annual research prizes that will be awarded to one young researcher from each of the three OMED Zones. The fourth will be separately awarded by the Research Committee. Winners will receive a commendation certificate, a plaque, grant of 1,000 USD, free registration to DDW and accommodation (2 nights) the awards will be presented at the OMED Governing Council dinner at DDW.

The real cutting edge

OMED participated in a NOTES symposium held in Hyderabad (India) this year in association with the Society of Gastrointestinal endoscopy of India (SGIE). The meeting was well attended and presented the newest ideas in this area of research. OMED has approved a new standing committee for surgical endoscopy in order to promote similar activities in the future.

Professional Awareness

OMED Website

The renovated OMED website has become user-friendly and informative. This valuable world-wide resource enables colleagues to access endoscopic material at no cost. We would like to add to the material and would be receptive to suggestions.

OMED e-newsletter

Inaugurated this year, our e-newsletter provides up-to-date information about what is happening in the endoscopic world. We have been profiling the OMED centers of excellence this year and have included videos from international meetings and a brain teaser. The newsletter is sent to those on our mailing list and can additionally be accessed from the website.

Gastro 2009

OMED and ESGE are jointly responsible for the endoscopic input to Gastro 2009 and we look forward to providing an interesting, practical and educational experience.

Live endoscopy will be transmitted from three of the OMED Centers of Excellence on each of the main days of the Congress. Video presentations, named lectures, research sessions, symposia and the presentation of working party reports will enhance the variety of our program.

On the Saturday and Sunday before the main meeting there is a first rate Postgraduate Course that will appeal to all endoscopists.

The OMED/ESGE Learning Area provides the opportunity for hands on learning with biologic models, and DVD teaching is also provided. Seminars with experts will be held in a small lecture theatre where a comprehensive program has been planned.

Future Activities

We anticipate many activities for the coming quadrennial session which will be presided over by our new President, Jerry Waye, supported by a new Council and Executive. We anticipate that projects that have been successful and are able to be funded will continue however we look forward to a greater emphasis on practical endoscopy training by setting up small, intensive  courses to teach the fundamentals of endoscopic teaching .

International congress of Endoscopy (ICE2011)

This one-off congress will be held in Los Angeles in September 2011 to celebrate the 50th anniversary of the coming together of an International Organization of Endoscopy separate from gastroenterology. Its goal is to bring together the medical and surgical societies of endoscopy in mutual cooperation to address the present and future needs of our specialty. The educational program will be of the highest quality, and stimulate new formats for the future.

Recognition

When the new executive took office we decided to turn OMED outwards to involve not just the elected members of the Council or members of standing committees but also national societies,  the leaders of world endoscopy, young endoscopists and those with the special talents that we needed to achieve our mission. Committee chairmen were encouraged to set up working parties  rather than to just rely upon a standing committee. As a result we have many colleagues throughout the world we must thank for their time, skill and the effort that they have put in over the last four years. We have identified more than 300 people who have made a significant contribution. It is impossible to thank each separately in the body of this report but we wish to recognize them and their names are listed in the addendum below (with apologies to any we have inadvertently missed).

I especially thank the OMED Executive for their unfailing support during my term of office. We have worked as a team and my colleagues have devoted enormous time and energy to keep OMED moving forward. Jerry Waye, our president elect in particular has consistently produced new and exciting ideas and the next term under his leadership will, I promise, be enterprising, educational and entertaining!

I thank the Governing Council for their invaluable input, their advice, hard work and for all that they have achieved, a number of them will continue to a second term and this will enable them to complete the projects that are still being pursued.

Our administrative secretariat led by Hilary Hamilton-Gibbs with Ruth Bucksch and Kristen Hartley have been the fulcrum of our activity. I thank them for their loyalty, efficiency, hard work and expertise. They have always been there when we needed them and much of OMED’s success can be laid at their door.

Finally I thank our Industrial Partners who provide us with a “no strings attached” annual allowance which enables OMED to function and pursue its mission. We are immensely grateful to them for their generosity and also for their forbearance when we go back to them with even more requests for help towards other additional projects that we feel are important and want to undertake. We endoscopists have always had a good relationship with Industry. Our aims are the same; we want endoscopy to prosper for the benefit of our patients, we hope that the close and cooperative relationship we have established will be maintained in the years to come. A list of our Industrial partners group is given below together with the names of other companies that have supported us over the past four years.

There has never before been such a prolonged and diverse period of growth in our sub-specialty.  I hope that the biomedical industry continues to innovate, that endoscopists remain adventurous and that our patients reap the benefits of our enterprise.

It has been a pleasure and a privilege for me to serve as your president and I thank the General Assembly for having done me this honor.

Professor Anthony T. R. Axon
President, World Organization of Digestive Endoscopy (OMED)