By Toyooki Sonoda
This e-book offers surgeons and gastroenterologists with state of the art options by way of complex colonoscopy. Chapters introduce equipment of elimination polyps that weren't formerly amenable to colonoscopic snare polypectomy. complicated suggestions similar to closure of perforations and intestinal stenting are broadly lined. The textual content continues a powerful emphasis on surgical/endoscopic method. broad dialogue on apparatus and talent acquisition is usually coated. As many readers won't ever have noticeable those complicated systems prior to, wide photos and movies are supplied. The authors offer suggestions, methods, and pitfalls that may support the reader comprise those new options into their practice.
Advanced Colonoscopy: Polypectomy and past should be of significant worth to any healthcare professional or gastroenterologist presently acting colonoscopy and drawn to complex techniques.
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Extra info for Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy
Therefore, in order to perform colorectal ESD safely and surely, it is necessary to possess knowledge and understanding of endoscopes and the accompanying instruments. Endoscope It is preferable for the endoscopes to be equipped with a water-jet system to wash away blood or mucus from the area of interest. ESD is principally carried out by using a single-channel upper gastrointestinal endoscope with a water-jet system (GIF-Q260J; Olympus Medical Systems Co, Tokyo, Japan), because of ease of manipulation of a more narrow scope.
Since their mechanical and electrical properties are different in how they cut, each knife must be used to understand the specific characteristics of a particular device. ESD devices are classified into those with noninsulated and insulated tips (Fig. 2a, b). Both knives also have a variety of merits and drawbacks. A variety of non-insulated tip-type knives exist, including the needle knife (KD1L-1; Olympus Medical Systems, Tokyo, Japan), FlexKnife (KD-630L; Olympus Medical Systems, Tokyo, Japan), DualKnife (upper length KD-650L and colonoscope length KD-650Q; Olympus Medical Systems, Tokyo, Japan), HookKnife (upper length KD-620LR and colonoscope length KD-620QR; Olympus Medical Systems, Tokyo, Japan), FlushKnife (Fujifilm Corporation), Splashneedle (PENTAX Medical, HOYA Corporation), Jet B-knife (Zeon Medical), and TriangleTipKnife (TT knife) (KD-640 L; Olympus Medical Systems, Tokyo, Japan).
The purpose of this chapter is to describe ways of dealing with difficult polyps endoscopically using conventional methods of polypectomy. What Is a “Difficult” Polyp? A difficult polyp is one that is not easy to remove. The definition of difficulty is subjective, however; what may be “difficult” for one colonoscopist may be straightforward for another. ” A polyp may be technically easy to remove, but because of its size and location, there may be a high risk of bleeding or perforation. This chapter focuses on polyps that are technically difficult to treat.