Scientific Program

The detailed agenda for the event.

An informal networking moment to meet faculty and participants, get oriented, and start the day in a relaxed, collegial atmosphere before the scientific program begins.

Introductory session outlining the goals of the workshop, the training format, and key safety principles, setting the tone for a focused, practical learning experience.

Station 1: The Difficult Colon Lab

Focus:

  • dolichocolon, post-surgical anatomy, severe diverticular disease
  • predictive loop management
  • knowing when to continue, stop, or refer

Skills Acquisition Pathway:

  1. Master scope handling – fine control of tip deflection, torque steering, and image stability.
  2. Recognize and manage loops – identify loop patterns and apply effective reduction maneuvers.
  3. Navigate efficiently – progress confidently to the cecum with correct anatomical orientation.
  4. Optimize mucosal inspection – apply washing, retroflexion, and detection of subtle flat lesions.

Outcome: Build the essential foundation required for all advanced endoscopic procedures.

Station 2: EUS – FNA /FNB Acquisition Lab

Skills Acquisition Pathway:

  1. Understand image orientation & anatomy – identify key structures and echogenic patterns.
  2. Target lesions with confidence – stabilize the echoendoscope and position the needle path.
  3. Perform needle puncture – coordinate needle movement precisely under real-time EUS guidance.
  4. Optimize tissue acquisition – practice suction, fanning, and core sampling techniques.
  5. Patient and lesion selection: when to sample — and when not to.
  6. FNA vs FNB decision logic: choosing the right technique for the clinical question.
  7. Needle selection: gauge, design, and indications.
  8. Scope position and stability: controlling the puncture platform.
  9. Needle techniques: fanning, torque, stroke length, suction strategy.
  10. Sample adequacy: what “good tissue” really means.
  11. Troubleshooting: bloody samples, insufficient cellularity, difficult access.

Outcome: Acquire the fundamental skills necessary for high-quality diagnostic EUS.

Station 3: EUS Decision Lab – Basic and Advanced Cyst Drainage

Drain, sample, observe... or walk away

  • FNA vs FNB selection
  • route planning for cyst drainage
  • knowing when not to puncture

EUS-LAMS Component – Skills Acquisition Pathway:

  1. Identify collections – understand EUS criteria for WON and pseudocyst drainage.
  2. Align scope and target – maintain a stable axis and assess distance to the collection.
  3. Deploy the LAMS stent – simulate cautery puncture, tract creation, and flange release.
  4. Confirm drainage – recognize signs of effective decompression.

Station 4: Polypectomy & EMR Lab

Not techniques. Decisions.

  • cold vs hot resection in 2026
  • fibrotic and non-lifting lesions
  • piecemeal vs en-bloc: outcome-driven choices

Skills Acquisition Pathway:

  1. Characterize lesions – determine when to use cold, hot, en-bloc EMR, or piecemeal resection.
  2. Perform submucosal lifting – create a safe and adequate dissection plane with proper injection.
  3. Control the snare effectively – practice optimal snare placement and activation.
  4. Manage complications – learn immediate strategies for bleeding or deep mural injury.

Outcome: Gain essential modern polypectomy and EMR competencies for screening and therapy.

Station 5: Hemostasis for beginners

Skills Acquisition Pathway:

  1. Recognize bleeding patterns – differentiate spurting, oozing, and exposed vessel lesions.
  2. Perform injection therapy – control depth and volume for effective tamponade.
  3. Apply mechanical hemostasis – place clips with accuracy and proper tissue capture.
  4. Use thermal modalities – practice targeted coagulation with controlled energy delivery.

Outcome: Develop a complete toolbox for rapid and reliable endoscopic hemostasis.

Station 6: Endoscopic Closure & Perforation Management Station

Stepwise strategies, not devices

  • TTS vs OTSC
  • sequential closure algorithms
  • recognizing when endoscopy should stop

Skills Acquisition Pathway:

  1. Identify defect types – distinguish mucosal, deep, and full-thickness injuries.
  2. Perform TTS clip closure – learn proper grasping, tissue approximation, and clip deployment.
  3. Use OTSC systems – practice closure of large or complex defects.
  4. Simulate endoscopic suturing – understand indications and basic suturing mechanics.

Outcome: Build confidence in managing endoscopic complications and restoring GI integrity.

Station 7: ESD Dissection Technique Station

Skills Acquisition Pathway:

  1. Mark and incise precisely – define lesion borders and create the initial mucosal entry.
  2. Identify the correct plane – work within the avascular submucosal layer for safe dissection.
  3. Use traction techniques – apply distal caps or clip-line methods for enhanced visibility.
  4. Perform targeted hemostasis – control bleeding without disrupting the dissection.

Outcome: Develop advanced precision skills for complete oncologic resections.

Station 8: Endoscopic sleeve gastroplasty

By the end of training, participants should be able to:

  • Describe indications, contraindications, and patient selection for endoscopic gastroplasty
  • Understand gastric anatomy relevant to safe full-thickness suturing
  • Recognize expected outcomes, limitations, and follow-up requirements
  • Identify potential adverse events and outline prevention and management
  • Achieve stable endoscopic positioning and orientation in the stomach
  • Create a structured suture pattern for gastric volume reduction
  • Maintain consistent tension and spacing between sutures
  • Recognize and correct technical errors during suturing
  • Recognize early signs of bleeding, pain, or leak
  • Initiate appropriate endoscopic or medical management strategies

Chairs: Bogdan Busuioc, Cosmin Caraiani, Laura Lucaciu, Ofelia Mosteanu, Radu Tudor Motocu, Teodora Atena Pop, Theodor Voiosu.

  • Altered anatomy + cholangitis: Bogdan Busuioc
  • When a capsule is too late: Laura Lucaciu
  • Iron deficiency anemia: your scope is not the end of the story: Teodora Pop.

Time to enjoy a meal, unwind, and continue informal discussions with faculty and colleagues.

In medicine, the terms medical error, complication, and assumed risk (or accepted/justified risk) have distinct meanings, both from a medical and a legal perspective, particularly with regard to the physician’s liability. Understanding the difference between error, complication, and assumed risk is essential not only in a litigation context, but especially in everyday clinical practice. A complication may occur even when the medical indication is correct and the procedure is performed in accordance with established protocols, whereas a medical error involves a deviation from the applicable standard of professional care. Assumed risk, in turn, requires that the patient be genuinely and properly informed, with such information being documented, rather than treated as a mere formality. This presentation aims to provide physicians with clear reference points for understanding these distinctions, supported by practical examples from daily practice, and to emphasize the role of documentation, communication, and sound medical decision-making in building professional legitimacy. The objective is not to create fear or promote defensive medicine, but to enhance safety in medical practice and reduce conflict through clarity, accountability, and balance.

Medical practice today is no longer limited to clinical care, professional competence, and the doctor–patient relationship. Regardless of the form of organization—solo practice, partnership, or medical company—physicians also carry out an economic activity that is subject to increasingly strict fiscal and legal regulations. In recent years, the tax framework has changed substantially. The digitalization of tax administration, the expansion of document-based audits, and the growing emphasis on compliance have made medical practices a constant focus of attention for tax authorities. In most cases, problems arise not from bad faith, but from a lack of basic information regarding fiscal obligations and the legal risks specific to the medical profession.
This conference starts from a simple reality: physicians do not need to be tax experts, but it is essential that they understand the basic mechanisms that directly affect their professional activity. Without this knowledge, decisions are either left entirely to the accountant or made “out of habit,” without properly assessing their medium- and long-term fiscal or legal consequences.
The purpose of our meeting is to provide a clear, pragmatic, and practical overview of the main tax and tax law issues relevant to medical practices. We will not focus on abstract theory, but on real and common situations that physicians face in daily practice: choosing the appropriate legal structure, tax regimes, VAT treatment, deductibility of expenses, contractual relationships with hospitals or private clinics, and the way a tax audit is conducted.
The course is structured to provide participants with concrete tools for tax risk prevention. We will analyze the fiscal differences between organizational forms, recurring payment obligations, the hidden risks of seemingly advantageous options, and the mistakes that most frequently lead to adjustments, penalties, or disputes with tax authorities.
An important section will be dedicated to tax audits, especially document-based audits, which have become increasingly frequent. We will discuss physicians’ rights, their obligations, the limits of tax authority intervention, and the recommended conduct to avoid the escalation of situations that can be managed smoothly when properly understood.
This course does not aim to turn physicians into accountants or lawyers, nor to promote strategies for avoiding tax obligations. On the contrary, the objective is correct and predictable compliance, which reduces risk, eliminates unnecessary stress, and allows physicians to focus on what truly matters: medical care.
In essence, well-understood taxation is not an obstacle, but a tool for professional protection. A fiscally informed physician is a more secure professional, better legally protected, and freer to practice medicine.

Facilitators: Catalina Bordianu and Ciprian Paun

A short pause to relax, recharge, and connect with colleagues between sessions.

Chairs: Gheorghe Balan, Bogdan Mateescu, Cristina Garbulet-Mocanu, Pradeep Mundre, Cristian Ioan Nedelcu, Andrei Voiosu, Bogdan Ungureanu
Lectures:

  • Endoscopic Sleeve Gastroplasty (ESG): How I Do It - Bogdan Mateescu

  • Post-procedure damage control: the procedure is over, the risk is not.

    1. Damage control algorithm: Gheorghe Balan
    2. Rescue corner (closure & practical pearls): Theodor Voiosu

  • Mastering ESD: key strategies, pitfalls, and technical pearls for difficult lesions – Pradeep Mundre

  • This lesion: EMR, ESD, eFTR or surgery?
    Endoscopic debate: resect or refer?

    1. Algorithm: Andrei Voiosu
    2. Case debate & voting: Cristian Ioan Nedelcu

  • EUS FNB when things go wrong: troubleshooting access, bloody samples, and failed tissue acquisition

    1. Troubleshooting: Bogdan Ungureanu
    2. Rescue decisions after failed sampling: Cristina Mocanu

Decisions and Practical Tips - Ofelia Moșteanu (Sandoz)

Phase 2 evaluation of a fully human high-affinity anti-TL1A antibody - Vlad Ichim (Arensia)

An informal evening reception, offering participants and faculty a relaxed setting to unwind, connect, and continue conversations in a friendly and collegial atmosphere.

Station 1: ERCP Cannulation & Therapeutic Techniques Station

Skills Acquisition Pathway:

  1. Identify papillary anatomy – understand variations and choose tailored cannulation strategies.
  2. Develop refined wire control – practice controlled guidewire advancement in biliary/pancreatic ducts.
  3. Achieve selective cannulation – follow step-by-step algorithms for safe and efficient access.
  4. Simulate therapeutic maneuvers – stenting, sphincterotomy, and stone extraction (demo).

Outcome: Gain the core competencies needed for safe and effective ERCP practice.

Station 2: EUS Decision Lab – Basic and Advanced Cyst Drainage

Drain, sample, observe... or walk away

  • FNA vs FNB selection
  • route planning for cyst drainage
  • knowing when not to puncture

EUS-LAMS Component – Skills Acquisition Pathway:

  1. Identify collections – understand EUS criteria for WON and pseudocyst drainage.
  2. Align scope and target – maintain a stable axis and assess distance to the collection.
  3. Deploy the LAMS stent – simulate cautery puncture, tract creation, and flange release.
  4. Confirm drainage – recognize signs of effective decompression.

Outcome: Master essential techniques for advanced EUS-guided therapeutic procedures.

Station 3: EUS – FNA/FNB Acquisition Lab

Skills Acquisition Pathway:

  1. Understand image orientation & anatomy – identify key structures and echogenic patterns.
  2. Target lesions with confidence – stabilize the echoendoscope and position the needle path.
  3. Perform needle puncture – coordinate needle movement precisely under real-time EUS guidance.
  4. Optimize tissue acquisition – practice suction, fanning, and core sampling techniques.
  5. Patient and lesion selection: when to sample — and when not to.
  6. FNA vs FNB decision logic: choosing the right technique for the clinical question.
  7. Needle selection: gauge, design, and indications.
  8. Scope position and stability: controlling the puncture platform.
  9. Needle techniques: fanning, torque, stroke length, suction strategy.
  10. Sample adequacy: what “good tissue” really means.
  11. Troubleshooting: bloody samples, insufficient cellularity, difficult access.

Outcome: Acquire the fundamental skills necessary for high-quality diagnostic EUS.

Station 4: Polypectomy & EMR Lab

Not techniques. Decisions.

  • cold vs hot resection in 2026
  • fibrotic and non-lifting lesions
  • piecemeal vs en-bloc: outcome-driven choices

Skills Acquisition Pathway:

  1. Characterize lesions – determine when to use cold, hot, en-bloc EMR, or piecemeal resection.
  2. Perform submucosal lifting – create a safe and adequate dissection plane with proper injection.
  3. Control the snare effectively – practice optimal snare placement and activation.
  4. Manage complications – learn immediate strategies for bleeding or deep mural injury.

Outcome: Gain essential modern polypectomy and EMR competencies for screening and therapy.

Station 5: PEG Beyond the Procedure: Decision & Risk Management Lab

Because PEG is simple—until it isn’t.
PEG Component – Skills Acquisition Pathway:

  1. Select a safe site – use transillumination and palpation to confirm landmarks.
  2. Perform puncture & guidewire placement – practice controlled access and wire advancement.
  3. Complete the PEG placement – simulate externalization and secure fixation of the tube.

Outcome: Master essential techniques for enteral access.

Station 6: Endoscopic Closure & Perforation Management Station

Stepwise strategies, not devices

  • TTS vs OTSC
  • sequential closure algorithms
  • recognizing when endoscopy should stop

Skills Acquisition Pathway:

  1. Identify defect types – distinguish mucosal, deep, and full-thickness injuries.
  2. Perform TTS clip closure – learn proper grasping, tissue approximation, and clip deployment.
  3. Use OTSC systems – practice closure of large or complex defects.
  4. Simulate endoscopic suturing – understand indications and basic suturing mechanics.

Outcome: Build confidence in managing endoscopic complications and restoring GI integrity.

Station 7: Electrosurgery without fear

  • Describe the basic principles of electrosurgery and the differences between cutting and coagulation currents.
  • Select appropriate electrosurgical settings and accessories for common endoscopic interventions.
  • Perform controlled tissue cutting and coagulation safely in simulated endoscopic scenarios.
  • Recognize and prevent thermal injury-related complications such as deep tissue damage, perforation, and delayed bleeding.
  • Apply safe equipment setup and troubleshooting techniques during electrocautery use.

Station 8: Stenting Lab: Acquisition Skills

Skills Acquisition Pathway:

  1. Mark and incise precisely – define lesion borders and create the initial mucosal entry.
  2. Identify the correct plane – work within the avascular submucosal layer for safe dissection.
  3. Use traction techniques – apply distal caps or clip-line methods for enhanced visibility.
  4. Perform targeted hemostasis – control bleeding without disrupting the dissection.

Outcome: Develop advanced precision skills for complete oncologic resections.

A short pause to relax, recharge, and connect with colleagues between sessions.

Bring the anonymous story of your most difficult patient from the previous week, and let's talk confidentially about the reality of it. Globally, health systems are facing the challenge of balancing growing costs with the well-being of patients and healthcare professionals alike. Who is the victim? Who is alleviating the pain and suffering of whom? Who is paying? Join an executive coaching conversation to change perspective in a rapidly changing world. "Who's Afraid of the Difficult Patient?" is a paraphrase of "Who's Afraid of Virginia Woolf?", an absurd tragicomedy about the need to give up certain illusions and pretenses to find a better way forward. The future of medicine begins today; we all contribute, and each of us has choices to make. Which will be yours?

Facilitator: Iulia Deac

Interconnected Mechanisms, Integrated Management - Ofelia Moșteanu, Teodora Pop (Zentiva)

Key element in the management of irritable bowel syndrome - Andrei Voiosu (Innergy)

Time to enjoy a meal, unwind, and continue informal discussions with faculty and colleagues.

Endoscopy is technique. Mastery is judgement.
Chairs: Gheorghe Balan, Bogdan Busuioc, Laura Lucaciu, Cristina Garbulet-Mocanu, Ofelia Mosteanu, Pradeep Mundre, Cristian Ioan Nedelcu, Teodora Atena Pop, Andrei Voiosu, Theodor Voiosu, Bogdan Ungureanu.
Lectures:

  • Endoscopic failure management. What happens after the complication. Ofelia Mosteanu
  • Piecemeal resection: acceptable or dangerous? – The non-lifting lesion: fight or walk away? Teodora Atena Pop
  • Sampling vs observing: the pancreatic cyst dilemma –is this FNA/FNB necessary – or harmful? Ofelia Mosteanu
  • The first 60 Seconds: what’s your plan? – Teodora Atena Pop

Panel expert: Clinical debate/How I do it

  • Public voting
  • Guideline vs Clinical practice

From Assistant to Procedural Partner: Advanced Nursing in Interventional Endoscopy

Duration: 90 minutes
Format: Interactive, practice-oriented workshop
Faculty: Angela Chereches, Dana Dan, Maria Elena Pop (Senior Endoscopy Nurses)

This dedicated session is designed exclusively for endoscopy nurses participating in the hands-on course. Structured as a highly practical and experience-driven workshop, it focuses on advanced procedural support, anticipation skills, and crisis response during interventional endoscopy.

The session emphasizes real-life workflow organization, instrument readiness, early recognition of complications, and effective team communication under pressure. Through live demonstrations, rapid-response scenarios, and peer-to-peer exchange, participants will explore how experienced nurses contribute decisively to procedural efficiency and patient safety.

This closed-format workshop aims to provide a psychologically safe environment for open discussion, shared experience, and professional identity consolidation within the endoscopy team.

Station 1: The Difficult Colon Lab

Focus:

  • dolichocolon, post-surgical anatomy, severe diverticular disease
  • predictive loop management
  • knowing when to continue, stop, or refer

Skills Acquisition Pathway:

  1. Master scope handling – fine control of tip deflection, torque steering, and image stability.
  2. Recognize and manage loops – identify loop patterns and apply effective reduction maneuvers.
  3. Navigate efficiently – progress confidently to the cecum with correct anatomical orientation.
  4. Optimize mucosal inspection – apply washing, retroflexion, and detection of subtle flat lesions.

Outcome: Build the essential foundation required for all advanced endoscopic procedures.

Station 2: EUS – FNA/FNB Acquisition Lab

Skills Acquisition Pathway:

  1. Understand image orientation & anatomy – identify key structures and echogenic patterns.
  2. Target lesions with confidence – stabilize the echoendoscope and position the needle path.
  3. Perform needle puncture – coordinate needle movement precisely under real-time EUS guidance.
  4. Optimize tissue acquisition – practice suction, fanning, and core sampling techniques.
  5. Patient and lesion selection: when to sample — and when not to.
  6. FNA vs FNB decision logic: choosing the right technique for the clinical question.
  7. Needle selection: gauge, design, and indications.
  8. Scope position and stability: controlling the puncture platform.
  9. Needle techniques: fanning, torque, stroke length, suction strategy.
  10. Sample adequacy: what “good tissue” really means.
  11. Troubleshooting: bloody samples, insufficient cellularity, difficult access.

Outcome: Acquire the fundamental skills necessary for high-quality diagnostic EUS.

Station 3: EUS Decision Lab – Basic and Advanced Cyst Drainage

Drain, sample, observe... or walk away

  • FNA vs FNB selection
  • route planning for cyst drainage
  • knowing when not to puncture

EUS-LAMS Component – Skills Acquisition Pathway:

  1. Identify collections – understand EUS criteria for WON and pseudocyst drainage.
  2. Align scope and target – maintain a stable axis and assess distance to the collection.
  3. Deploy the LAMS stent – simulate cautery puncture, tract creation, and flange release.
  4. Confirm drainage – recognize signs of effective decompression.

Outcome: Master essential techniques for advanced EUS-guided therapeutic procedures.

Station 4: PEG Beyond the Procedure: Decision & Risk Management Lab

Because PEG is simple—until it isn’t.
PEG Component – Skills Acquisition Pathway:

  1. Select a safe site – use transillumination and palpation to confirm landmarks.
  2. Perform puncture & guidewire placement – practice controlled access and wire advancement.
  3. Complete the PEG placement – simulate externalization and secure fixation of the tube.

Outcome: Master essential techniques for enteral access.

Station 5: Bleeding Under Pressure: Advanced Endoscopic Hemostasis Lab

30 seconds to decide

  • time-limited bleeding simulations
  • prioritization and leadership under stress
  • algorithm-based decision-making

Station 6: ENDOSCOPIC FULL THICKNESS RESECTION – eFTR

LEARNING OBJECTIVES

By the end of this station, participants will be able to:
KNOWLEDGE

  • Describe the role of endoscopic full-thickness resection (eFTR) in managing difficult colorectal lesions
  • Identify appropriate INDICATIONS AND CONTRAINDICATIONS for eFTR
  • Understand the components and function of the FULL-THICKNESS RESECTION DEVICE (FTRD) by OVESCO ENDOSCOPY AG
  • Recognize potential adverse events and basic management principles

TECHNICAL SKILLS
Participants will practice and demonstrate:

  • Lesion assessment and margin marking
  • Correct mounting and checking of the FTRD system
  • Safe tissue grasping and complete inversion into the cap
  • Controlled clip deployment for full-thickness closure
  • Snare resection above the clip
  • Post-resection site inspection and immediate bleeding management

NON-TECHNICAL SKILLS

  • Appropriate case selection
  • Procedural planning and stepwise communication
  • Anticipation of complications

GOAL OF THE STATION:

  • Develop safe, structured, and reproducible technique for endoscopic full-thickness resection in a simulated setting.

Station 7: ESD Dissection Technique Station

Skills Acquisition Pathway:

  1. Mark and incise precisely – define lesion borders and create the initial mucosal entry.
  2. Identify the correct plane – work within the avascular submucosal layer for safe dissection.
  3. Use traction techniques – apply distal caps or clip-line methods for enhanced visibility.
  4. Perform targeted hemostasis – control bleeding without disrupting the dissection.

Outcome: Develop advanced precision skills for complete oncologic resections.

Station 8: Stenting Lab: Acquisition Skills

Skills Acquisition Pathway:

  1. Mark and incise precisely – define lesion borders and create the initial mucosal entry.
  2. Identify the correct plane – work within the avascular submucosal layer for safe dissection.
  3. Use traction techniques – apply distal caps or clip-line methods for enhanced visibility.
  4. Perform targeted hemostasis – control bleeding without disrupting the dissection.

Outcome: Develop advanced precision skills for complete oncologic resections.

Interactive discussion, real cases, no slides

  • Endoscopic competency under the lesser umbrella: strategies from a regional hospital case!- Cristina Bura
  • Stepping in when others stepped back: regional surgical treatment of a complex liver abscess – Adrian Circo
  • Overdiagnosis leading to complication: a case of unnecessary intervention – Ioana Marchis
  • Not treating is also a decision: rebleeding from a bulbar ulcer in a young patient with hemophilia – Monica Pantea

Final remarks summarizing key learning points, reflections from faculty and participants, and a formal conclusion to the workshop program.