Usefulness of a handmade distal endoscope attachment with a transparent tape.
Ontology highlight
ABSTRACT:
SUBMITTER: Kurebayashi M
PROVIDER: S-EPMC7280143 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The purpose of the study is to compare the efficacy of device assisted colonoscopy (DAC) with standard colonoscopy (SC) in detecting adenomas in a randomized fashion.
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Project description:Background and aimsIntraoperative perforation is a major adverse event of endoscopic submucosal dissection (ESD). To avoid perforation, it is important for the endoscope to approach the portion to be resected carefully and to ensure that the knife can approach the submucosa at an angle parallel to the muscle layer. The multibending endoscope has 2 bends at its tip and may facilitate the ESD procedure. To the best of our knowledge, very few studies have reported the use of the multibending endoscope during gastric ESD. The aim of this study was, therefore, to introduce the usefulness of the multibending endoscope for gastric ESD.MethodsWe report 2 cases of early gastric cancer in which ESD was performed using a multibending endoscope.ResultsUnlike conventional single-bending endoscopes that have only 1 moveable part, the multibending endoscope allowed difficult areas to be approached more easily. Small adjustments could be made to the upward or downward angle of both the first and the second bending sections of the endoscope. This ensured that the knife would approach the submucosa at an angle parallel to the muscle layer. In patient 1, initially the conventional endoscope was used, but it became more difficult to approach the site, and paradoxic movement occurred. When the conventional endoscope was changed to the multibending endoscope, the ESD procedure became safer and more efficient. Another ESD using the multibending endoscope was performed successfully without any adverse events.ConclusionsThe use of a multibending endoscope for ESD will enable safer and faster treatment of patients.
| S-EPMC6895728 | biostudies-literature
Project description:The usefulness of endoscope-assisted microsurgical removal of vestibular schwannomas in the internal auditory canal (IAC) was evaluated. Microsurgical removal using the endoscope was done in 28 procedures and microsurgical removal without an endoscope was done in 43 procedures. A retrosigmoid approach was used. The tumor location in the IAC was classified as grade 1 (located up to the mid-portion), 2, 3, or 4 (located up to the fundus with bony destruction) according to the tumor extent, and residual tumor in the IAC was evaluated as grade A (remnant tumor was not observed), B, C, or D (remnant tumor was observed over the mid-portion) according to the extent of remnant tumor. The residual tumor in the IAC was less in the endoscope-assisted group than in the microsurgery group. There was a significant difference only in grade 2, that is, tumor located beyond the mid-portion of the IAC. There was no significant difference in the results of preservation of useful hearing, facial nerve function, and tumor recurrence between the two groups. The benefit of endoscope-assistance microsurgery was shown for those patients whose tumors extended beyond the mid-portion of the IAC but did not reach the fundus.
| S-EPMC3424024 | biostudies-other
Project description:The gastrointestinal tract is a challenging anatomical target for diagnostic and therapeutic procedures for bleeding, polyps and cancerous growths. Advanced endoscopes that combine imaging and therapies within the gastrointestinal tract provide an advantage over stand-alone diagnostic or therapeutic devices. However, current multimodal endoscopes lack the spatial resolution necessary to detect and treat small cancers and other abnormalities. Here we present a multifunctional endoscope-based interventional system that integrates transparent bioelectronics with theranostic nanoparticles, which are photoactivated within highly localized space near tumours or benign growths. These advanced electronics and nanoparticles collectively enable optical fluorescence-based mapping, electrical impedance and pH sensing, contact/temperature monitoring, radio frequency ablation and localized photo/chemotherapy, as the basis of a closed-loop solution for colon cancer treatment. In vitro, ex vivo and in vivo experiments highlight the utility of this technology for accurate detection, delineation and rapid targeted therapy of colon cancer or precancerous lesions.
| S-EPMC4674684 | biostudies-literature
Project description:Indocyanine green (ICG) is a cyanine dye useful for visualizing blood vessels; it has been developed for endoscopy and is used in skull base surgery. Endoscopy is widely used for hematoma removal after an intracerebral hemorrhage since it is minimally invasive and has a shorter operation time than craniotomy. However, with this technique the surgical field is limited and it is difficult to obtain an adequate orientation; thus, it is challenging to locate the bleeding point, and postoperative rebleeding has been reported. We performed intraoperative ICG near-infrared fluorescence imaging to locate the bleeding point. This purpose of this study was to evaluate the usefulness of ICG angiography during endoscopic hematoma removal in two patients, using two endoscope types and comparing their visualization of perforating branches during the procedure. ICG angiography was performed in two different cases of putaminal hemorrhage, using the SPIES NIR/ICG-System and IMAGE1 S Rubina (both KARL STORZ, Tuttlingen, Germany) at the intraoperative bleeding site. The intraoperative use of ICG allowed the clear visualization of the perforating branches and real-time confirmation of active bleeding. We could also distinguish an old hematoma from the active bleeding point. The IMAGE1 S Rubina has adequate brightness for contrast enhancement, allowing surgical manipulation simultaneously to the enhancement phase.ICG fluorescence angiography is useful to identify the damaged vessel and perform hemostasis. We expect other similar devices to be developed in the future, accompanied by flexible and thin rigid endoscopes.
| S-EPMC9894616 | biostudies-literature
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Primary outcome(s): Adenoma detection rate(ADR)
Study Design: Parallel
| 87667 | ecrin-mdr-crc
Project description:OBJECTIVE: To demonstrate normal and abnormal findings of distal brachialis tendon attachment in cadavers, normal volunteers and patients by means of ultrasound. METHODS: 3 cadaveric specimens, 30 normal volunteers and 125 patients were evaluated by means of ultrasound. Correlative MRI was obtained in volunteers. RESULTS: In all cases, ultrasound demonstrated the distal brachialis tendon shaped by two distinct tendons belonging to the deep head and superficial head of the brachialis muscle. Correlative MRI demonstrated that the brachialis is composed of two distinct tendons in 83% of volunteers (25/30). In the patient group, four avulsions with bony detachment involving the deep head, one delayed onset muscular soreness and three tendinous detachments with no bony avulsion involving one or two tendons were identified. The four patients with bony avulsion were immediately referred to the orthopaedic surgeon for a pre-surgical evaluation. Patients without bony avulsion were not referred to the surgeon. CONCLUSION: Detailed anatomy of the distal tendon is discernible in 100% of cases with ultrasound. There are two distinct tendons, and ultrasound can differentiate isolated lesions. In patients with distal brachialis tendon lesions, ultrasound may modify the clinical management of the patient. Advances in knowledge Detailed anatomy of the distal brachialis tendon is discernible with ultrasound and there are two distinct tendons.
| S-EPMC3635801 | biostudies-other
Project description: Not available
| S-EPMC7426655 | biostudies-literature
Project description:BACKGROUND:Colorectal endoscopic submucosal dissection (ESD) is an effective but challenging procedure. To facilitate ESD, several methods that apply traction are available; however, the optimal one remains to be established. The aim of this study was to evaluate the feasibility and safety of the double-endoscope assisted ESD (DEA-ESD) by improving traction to treat complex colorectal lesions. METHODS:Naïve or previously treated lesions in the rectum and sigmoid colon were included. A grasping forceps advanced through a small-caliber endoscope (GIF-XP190N, Olympus Medical Systems, Tokyo, Japan, 5.4 mm outer diameter) was used to apply traction to the mucosal flap. Lesions were deemed complex when they exceeded a total of nine points on the SMSA scoring system (size, morphology, site, and access) and recurrent when they were previously treated with endoscopic mucosal resection (EMR). Outcome measures included procedural success, total procedure time, complications, and recurrence rate at 3-month follow-up. RESULTS:Nine patients (mean age 62.3?±?14.5 years) were included; five had rectal and four had tumors in the sigmoid colon. The median SMSA score was 14 (SMSA Level IV-complex polyp), while three patients were pre-treated with EMR. DEA-ESD was technically feasible in all cases. En bloc resection and R0 resection rates were 100%, respectively, with a mean procedure time of 128.4?±?54.1 min. No immediate or delayed complications occurred. CONCLUSIONS:DEA-ESD is a feasible and safe method for treating complex or recurrent tumors in the rectum and distal colon.
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