By Toyooki Sonoda
This publication offers surgeons and gastroenterologists with state of the art ideas when it comes to complicated colonoscopy. Chapters introduce tools of removal polyps that weren't formerly amenable to colonoscopic snare polypectomy. complicated recommendations corresponding to closure of perforations and intestinal stenting are widely coated. The textual content continues a robust emphasis on surgical/endoscopic approach. wide dialogue on apparatus and ability acquisition is additionally lined. As many readers won't ever have noticeable those advanced approaches sooner than, large photos and videos are supplied. The authors supply tips, tips, and pitfalls that may aid the reader contain those new ideas into their practice.
Advanced Colonoscopy: Polypectomy and past should be of serious price to any health professional or gastroenterologist at present appearing colonoscopy and attracted to complicated techniques.
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Extra resources for Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy
Yamamoto H, Sekine Y, Higashizawa T, Kihira K, Kaneko Y, Hosoya Y, et al. Successful en bloc resection of a large superficial gastric cancer by using sodium hyaluronate and electrocautery incision forceps. Gastrointest Endosc. 2001;54(5):629–32. 14. Yamamoto H, Kawata H, Sunada K, Satoh K, Kaneko Y, Ido K, et al. Success rate of curative endoscopic mucosal resection with circumferential mucosal incision assisted by submucosal injection of sodium hyaluronate. Gastrointest Endosc. 2002;56(4):507–12.
Currently available insulated tip-type knives include the IT knife (KD-610L; Olympus Medical Systems, Tokyo, Japan), SAFEKnife (Fujifilm Corporation), ClutchCutter (Fujifilm Corporation), and Mucosectom (PENTAX Medical, HOYA Corporation). The devices can cut and dissect the submucosal layer of the lesion using not the tip but the “blade” portion of the knife. This makes the dissection faster, although maneuvering these knives is slightly difficult. The basic technique for using insulated tip types of devices involves the ability to pull or slide the device laterally from side to side.
Another benefit of a straight scope is that it allows easy rotation to position the polyp in the most favorable position for snaring. 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.