By Toyooki Sonoda
This booklet presents surgeons and gastroenterologists with state of the art suggestions by way of complicated colonoscopy. Chapters introduce tools of elimination polyps that weren't formerly amenable to colonoscopic snare polypectomy. complex recommendations corresponding to closure of perforations and intestinal stenting are generally coated. The textual content keeps a powerful emphasis on surgical/endoscopic method. large dialogue on gear and talent acquisition is usually coated. As many readers won't ever have obvious those advanced tactics sooner than, huge photos and videos are supplied. The authors offer tips, tips, and pitfalls that might support the reader comprise those new options into their practice.
Advanced Colonoscopy: Polypectomy and past should be of serious price to any doctor or gastroenterologist at the moment acting colonoscopy and drawn to complicated techniques.
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Additional resources for Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy
Snare Polypectomy (Fig. 1a) This kind of procedure is especially useful for pedunculated lesions. An electrocautery snare is passed over the polyp and around the stalk of the polyp. The loop of the snare is tightened. An electric current is then passed through the snare loop. In case the stalk is thick, the stalk is ligated using an endoclip or endoloop before resection for prophylaxis of bleeding. 2 Instruments used to carry out EMR • • • • • • High-frequency electrosurgical generator Snare Needle for submucosal injection Injection solution Endoclips Device for specimen retrieval 34 M.
2002;56(4):507–12. 15. Ishiguro A, Uno Y, Ishiguro Y, Munakata A, Morita T. Correlation of lifting versus non-lifting and microscopic depth of invasion in early colorectal cancer. Gastrointest Endosc. 1999;50(3): 329–33. 16. Rutter MD, Nickerson C, Rees CJ, Patnick J, Blanks RG. Risk factors for adverse events related to polypectomy in the English Bowel Cancer Screening Programme. Endoscopy. 2014;46(2):90–7. 17. Conio M, Ponchon T, Blanchi S, Filiberti R. Endoscopic mucosal resection. Am J Gastroenterol.
This is at “6 o’clock,” where the therapeutic channel is located. A straight scope also facilitates retroversion of the tip, an important part of technique for dealing with polyps on the reverse side of a fold. Finally, a straight scope means a more comfortable patient and one who is more likely to be cooperative. Therefore, insertion technique should produce a straight scope to the cecum. Polypectomy should usually be performed during scope withdrawal, when the scope is straight. Piecemeal or En Bloc Jerry Waye has advised that the maximum “bite” that should be removed during one application of the snare is 2 cm .
Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy by Toyooki Sonoda