Purpose of the study. To present the initial results of endoscopic gastroplasty in the treatment of patients with obesity. Materials and Methods. Between April and November 2025, endoscopic gastroplasty was performed in 11 patients with obesity. The study group was predominantly female (9 out of 11 patients), with 2 males. The mean age was 41 years. The average body mass index was 42 kg/m2, and the mean excess body weight was 45 kg. In all cases, the most effective technique according to current data - the placement of “U-shaped” sutures - was used to evenly reduce gastric volume, with 8 to 10 stitches performed per procedure. Six patients received four U-shaped sutures, four patients received five sutures, and one patient received three sutures. Results. Technical success was achieved in all cases. The average length of hospital stay was four days. At the three-month follow-up, the mean weight loss was 18 kg, and the average percentage of excess weight loss reached 30%. Conclusion. Endoscopic intraluminal gastroplasty is a modern, minimally invasive technique for the treatment of obesity within bariatric surgery. According to the literature and our own observations, this technology is characterized by stable functional outcomes, a low complication rate, and a short postoperative period, enabling rapid recovery and return to normal activities without the need for prolonged rehabilitation.

Since September 1, 2025, Order of the Ministry of Health of the Russian Federation No. 206n regulating endoscopic examinations has come into force. The study presents a comprehensive analysis of organizational, legal, staffing and epidemiological aspects of endoscopy service functioning under new regulatory conditions. The order significantly strengthens the clinical role of the endoscopist, digitalization and safety requirements. However, regulatory gaps remain in time standards, sedation regulation and electronic archives. The implementation of the order requires methodological support, staffing modernization and legal protection mechanisms for endoscopists.

Granular cell tumor is a rare mesenchymal neoplasm of neurogenic origin. The clinical course of GCT is mostly asymptomatic. In the gastrointestinal tract, it usually presents as a submucosal lesion detected during routine endoscopic examination. The article presents the experience of managing patients at the GBUZ Moscow Clinical Scientific Center named after Loginov MHD from 2017 to 2025.

Duodenal tumors (duodenal tumors) are rare neoplasms of the gastrointestinal tract and are characterized by significant clinical and pathological heterogeneity. Depending on the phenotype of mucin, intestinal and gastric types of tumor lesions are distinguished, differing in localization, risks of submucosal invasion and lymphogenic metastasis. The most common malignant neoplasm of the duodenum is adenocarcinoma, with tumors predominantly localized in the descending intestine. The choice of therapeutic tactics depends on the size of the formation, the depth of invasion and the involvement of vascular structures, while endoscopic removal methods are widely used in the early stages of the disease. Objective: to demonstrate the possibilities of a combined endoscopic approach (EMR and ESD) for the removal of a nonampular tubulo-villous tumor of the descending part of the duodenum. Materials and methods: a clinical case of a 67-year-old patient with epithelial formation of the descending part of the duodenum up to 30 mm in size, revealed by esophagogastroduodenoscopy, is presented. According to the radiation examination methods, no signs of transmural growth were detected. Initially, submucosal dissection was performed, complicated by intraoperative bleeding, and therefore the tactics were changed to endoscopic resection of the mucous membrane. Results: The tumor was removed fragmentarily within the unchanged mucous membrane. The removal was accompanied by active bleeding. Hemostasis was successfully achieved using coagulation, local administration of epinephrine, and systemic hemostatic therapy. According to the pathological and anatomical examination, tubulo-villous adenoma with foci of severe epithelial dysplasia was diagnosed. No complications were noted in the postoperative period, and control endoscopic examinations revealed complete epithelialization of the resection area.

The aim of the study was to compare the incidence of colorectal cancer between colon segments and the molecular genetic characteristics of the mucosa of index colon segments. Materials and methods: A comprehensive retrospective study of 7,185 colonoscopies was conducted. A prospective study (2022-2023) of the colonic mucosa was performed in 152 patients with CRC. Results: An assessment of the CRC frequency by colon segment from all detected CRC cases revealed a predominance of the sigmoid and rectum, consistent with existing data. However, an analysis of the CRC frequency among all neoplasms in a specific colon segment revealed a predominance of the cecum, sigmoid, and rectum. An assessment of the differences in these indicators revealed unexpected discrepancies for the cecum, ascending colon, and descending colon. Mucosal morphometry revealed increasing differences in measurement parameters from the ascending colon to the sigmoid colon. Molecular genetic characteristics of the index segments for some of the studied parameters showed significant differences both between colon segments and between colon halves. However, among colon segments, there was heterogeneity in parameters that was inconsistent with the combined assessment of the colon halves. Conclusion: In colorectal cancer, there is morphological and genetic heterogeneity in the mucosa between different segments of the colon, which is not consistent with the differences in CRC incidence between the right and left halves of the colon. The identified differences between the outer colon and the colonic segments require further evaluation.

Purpose of the study. To present the experience of successful endoscopic treatment of a patient with early cancer of the major duodenal papilla. Clinical case. A 69-year-old patient underwent treatment at the A.V. Vishnevsky National Medical Research Center of Surgery for early cancer of the major duodenal papilla (pT1a). Results. The patient with early cancer of the major duodenal papilla underwent successful combined endoscopic treatment using resection techniques in combination with intraductal radiofrequency ablation under cholangioscopic guidance. The total duration of treatment was 6 months, and the recurrence-free period was 25 months. Conclusion. The use of minimally invasive endoscopic technologies in the treatment of a patient with early cancer of the major duodenal papilla made it possible to achieve a favorable clinical outcome and avoid highly traumatic surgical intervention.

Introduction. Endoscopic submucosal dissection is an effective minimally invasive technique for the removal of «difficult» epithelial neoplasms of the gastrointestinal tract. These procedures require advanced specialized equipment, strict adherence to organizational and technical standards, and coordinated teamwork within the endoscopy unit, in which the endoscopy nurse plays a crucial role. Objective. To describe the principles of operating room preparation and the specific features of assistance during endoscopic submucosal dissection in the colon. Materials and Methods. The study is based on an analysis of regulatory documents governing endoscopic procedures, including regulations of the Ministry of Health of the Russian Federation, sanitary regulations, national clinical guidelines, and international recommendations. Particular attention was paid to the requirements for operating room equipment and its preparation for endoscopic procedures in accordance with a developed checklist. Results. The paper describes the technical aspects of performing endoscopic submucosal dissection at different stages of the procedure, including lesion assessment, submucosal injection, mucosal incision, submucosal dissection, the use of traction techniques, and specimen fixation. The important role of the endoscopy nurse in assisting the endoscopist, ensuring the quality and safety of procedures, and handling modern endoscopic equipment is emphasized. Conclusion. Endoscopic submucosal dissection is a complex procedure that requires advanced technical equipment, highly trained staff, and efficient workflow organization.