the ‘pull to the North’ became overwhelming for me ‐ back to where I grew up ‐ and in 2004 I took the difficult and painful decision to leave John, Alan, Simon and Rob and move to the relative peds GI virgin territory of Sheffield Children’s Hospital. Back to ‘God’s Own County’, Yorkshire. Thanks to Kay, my incredible and long‐suffering partner for agreeing and sacrificing her promising career in ‘Pharma’ to which she had made a transfer and a name for herself in a short time. I appreciate it more than you can know.
So, now a blank canvas ‐ almost. Prof Chris Taylor was the only paeds GI there when I arrived on, fittingly, April the 1st 2005. I remember that in the very first list I broke their only colonoscope! Oops! Time to get some more then. . . . . . .
Chris was a very generous host and indulged my ambitions. He was even kind enough as we became friends to ask me to be his best man and I was delighted ‐ only embarrassing him slightly.
In 2005 we carried on with the Royal Free Course but then transferred it to Sheffield the year after and converted it to a Hands‐On small group ileo‐colonoscopy Course over 2–3 days. This was to be the template for the nest 15 years and has increased in frequency driven by demand to about 6–8 a year.
Meanwhile we began to build the Unit and with my colleagues and friends we have now over 50 staff. Prof Chris Taylor and Prof Stuart Tanner (hepatology) retired (Chris only recently) and I was joined by consultant colleagues Sally Connolly (now also retired), David Campbell, Prithviraj Rao, Priya Narula, (temporarily Dalia Belsha, Franco Torrente and Camilla Salvestrini), Arun Urs, Natalia Nedelkopoulou, Shishu Sharma, Zuzana Londt, Intan Yeop and Akshay Kapoor. Amazing team who all bring something different to the table. The Gastro Nurses are so important to us led very ably by Valda Forbes. Dietitians also brilliant led by Lynn Hagin, SALT by Jane Shaw, and psychology by Charlotte Merriman are also hugely important and fantastic. Prof Marta Cohen, head of histopathology and I have collaborated on research over the years and she is always energetic and a great colleague to have.
The people of Sheffield and the region are, contrary to popular belief of a Yorkshireman being a ‘Scotsman robbed of his generosity’, incredibly generous. The Sheffield Children’s Hospital Charity (led by my friend David Vernon‐Edwards) were, and have been, pivotal in financial help to make the Unit the most fantastic place to work ‐ the Endoscopy Unit of the Future, the double balloon enteroscopy set up, the wireless capsule endoscopy service and the new magnetic‐controlled capsule technology, and most recently the Symbionix virtual endoscopy training simulator, are amongst a few of the things that they have kindly and generously funded for us, allowing us to stay at the cutting edge of training and diagnostic and endo‐therapeutic capability.
An area that I am particularly happy with is the ESPGHAN Council’s open‐minded approach to the Endoscopy Special Interest Group initiatives in terms of Training. Hands‐On Courses are spreading, the Endoscopy Learning Zone at the Annual Meeting has been fantastic and is going from strength to strength under the guidance now of Prof Raoul Furlano, and the first ever live endoscopy session occurred in 2019 in Glasgow at the Annual ESPGHAN Meeting and was very well received. There is nothing like performing live endoscopy to 500 people to get the cardiovascular system energised! Thank you to the recent Presidents of ESPGHAN Raanan Shamir and the ever‐enthusiastic Sanja Kolacek. Sanja has pushed for, and obtained funding for, the ESPGHAN Pediatric Endoscopy Fellowships which are starting in early 2021, which will be amazing ‐ thank you!
My endoscopic ‘raison d’être’ is to attempt to put the paediatric surgeons out of work! Hence pushing the boundaries in such areas as are covered in this Textbook. Nevertheless, I think it is critical that we work hand in hand with our surgical colleagues, many of who perform endoscopy, in order to blur the interface between our approaches. I am extremely fortunate to work with some fantastic and enlightened individuals in the surgical team and we are almost a joint Unit nowadays – as can be seen by our innovations with laparoscopic assisted endoscopic percutaneous jejunostomy and duodenal web division, amongst many others. Maybe I am a frustrated surgeon after all! Hopefully the web page is educational to those that access it with many videos etc. I am particularly indebted to the open‐minded attitude and team‐spirited nature of Mr Sean Marven, Mr Richard Lindley, Prof Ross Fisher, Mr Suresh Murthi, Prof Prasad Godbole, Ms Emma Parkinson, and more recently Ms Liz Gavens and Ms Caroline McDonald. Sparring with Jenny Walker was always fun and we are now good friends. Rang Shawis and Julian Roberts should not be missed out here.
Endoscopy in the modern world in children could not occur ‐ especially endo‐therapeutic ‐ without the excellence of our anaesthetists ‐ my stars are Dr David Turnbull, Dr Liz Allison, Dr Kate Wilson, Dr Rob Hearn, Dr George Colley at the Royal Free, and most importantly of all, the best paediatric anesthetist of them all, Dr Adrian Lloyd‐Thomas (AL‐T). A quick story ‐ the modern practice of topical application of Mitomycin C after esophageal dilation came from a chance conversation with AL‐T, who told me that the ENT guys used Mitomycin C post‐laryngeal reconstruction to prevent circumferential stenosis ‐ we tried it and it worked in the esophagus of a girl requiring multiple frequent esophageal dilation. Cue a paper in The Lancet. Perhaps we should have more cross‐specialty conversations?
We should remember that this is the only truly ‘procedure‐specific’ paediatric specialty and stick to our guns with respect of the importance of endoscopy in our training. The Guidelines and Position Papers, some joint with ESGE and NASPGHN have been extremely well received and, in addition, have helped in raising the JPGN Impact Factor to its new dizzying height of nearly 3.
Medicine is a vocation amongst us of course, and training the next generation has been one of my major aims. In this I am particularly grateful to Prof Sanja Kolacek in her unswerving support and application of her considerable energy in moving forward the recent amazing ESPGHAN Endoscopy Fellowship Program ‐ worth mentioning again!
We should, in my view, never compromise on the quality of training or care delivery afforded by paediatric endoscopy by those of us fortunate enough to have benefitted by it in our careers. Adult GI endoscopists should be involved only if we cannot avoid it ‐ that comes down to our learning the correct skills and techniques and making their involvement redundant. We still have plenty to learn from them though, I will acknowledge.
Recently we have created a global community for Pediatric Endoscopy ‐ adult GI, European, North American, South American, Asian, Australasian Peds GI ‐ and Joint Endoscopy Guidelines have emerged – this is fantastic and I am sure that this fruitful collaboration will continue. Special mention should go to the drivers of these collaborative efforts and the contributors ‐ Catharine Walsh, Doug Fishman, Jenifer Lightdale, Jorge Amil‐Dias, Andrea Tringali, Mario Vieira, Raoul Furlano, Victor Fox, Looi Ee, Patrick Bontems, Matjaz Homan, Rok Orel, Frederick Gottrand, Alexandra Papadopoulou, Salvatore Oliva, Erasmo Miele, Claudio Romano, Luigi Dall’Oglio, Rob Kramer, Mike Manfredi, Diana Lerner, Marsha Kay, Tom Attard, Warren Hyer, Joel Freidlander, ‘The Richards’ Hansen and Russell, David Wilson, Dan Turner, Pete Gillett, Pat McKiernan, Stephen Murphy, Christos Tzivinikos, Ari Silbermintz, Rupert Hinds, Marta Tavares, Bruno Hauser, Yvan Vandenplas, Ron Bremner, Pete Lewindon, Petar Mamula, Orin Ledder, Merit Tabbers, Ilse Broekaert, Cesare Hassan, Marc Benninga, Alessandro Zambelli, Nikhil Thapar, Iva Hojsak, Stefan Husby, Ilektra Athiana, Andreia Nita, Sara Isoldi, Paola DeAngelis, Lissy De Ridder, the incomparable Samy Cadranel, all in the Sheffield Team and many many more ‐ apologies if I have missed you out!
Thank you to the numerous members of the endoscopy Companies that have been so helpful over the years with Courses etc etc. You will know who you are but to numerous to mention here.
Kevin and Kat in ESPGHAN Head Office have always been very receptive to any Qs needed and I am grateful to them.
There is no ceiling to what we can achieve in pediatric endoscopy. Attending ‘adult’ GI and endoscopy meetings is illuminating e.g. ‘ESGE Days’. We are no longer the Cinderella part of pediatric
