Journal articles on the topic 'Endoscopy'
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Cheng, Shih-Hao, Yen-Tsung Lin, Hsin-Tzu Lu, Yu-Chuan Tsuei, William Chu, and Woei-Chyn Chu. "The Evolution of Spinal Endoscopy: Design and Image Analysis of a Single-Use Digital Endoscope Versus Traditional Optic Endoscope." Bioengineering 11, no. 1 (January 20, 2024): 99. http://dx.doi.org/10.3390/bioengineering11010099.
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Spinal endoscopy has evolved significantly since its inception, offering minimally invasive solutions for various spinal pathologies. This study introduces a promising innovation in spinal endoscopy—a single-use digital endoscope designed to overcome the drawbacks of traditional optic endoscopes. Traditional endoscopes, despite their utility, present challenges such as fragility, complex disinfection processes, weight issues, and susceptibility to mechanical malfunctions. The digital endoscope, with its disposable nature, lighter weight, and improved image quality, aims to enhance surgical procedures and patient safety. The digital endoscope system comprises a 30-degree 1000 × 1000 pixel resolution camera sensor with a 4.3 mm working channel, and LED light sources replacing optical fibers. The all-in-one touch screen tablet serves as the host computer, providing portability and simplified operation. Image comparisons between the digital and optic endoscopes revealed advantages in the form of increased field of view, lesser distortion, greater close-range resolution, and enhanced luminance. The single-use digital endoscope demonstrates great potential for revolutionizing spine endoscopic surgeries, offering convenience, safety, and superior imaging capabilities compared to traditional optic endoscopes.
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Denton, O., P. Brahmabhatt, J. Ahmed, and A. Sanu. "Three-dimensional versus two-dimensional endoscopes in anatomical orientation of the middle ear and in simulated surgical tasks." Journal of Laryngology & Otology 136, no. 2 (January 10, 2022): 141–45. http://dx.doi.org/10.1017/s002221512200010x.
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AbstractBackgroundThree-dimensional endoscopes provide a stereoscopic view of the operating field, facilitating depth perception compared to two-dimensional systems, but are not yet widely accepted. Existing research addresses performance and preference, but there are no studies that quantify anatomical orientation in endoscopic ear surgery.MethodsParticipants (n = 70) were randomised in starting with either the two-dimensional or three-dimensional endoscope system to perform one of two tasks: anatomical orientation using a labelled three-dimensional printed silicone model of the middle ear, or simulated endoscopic skills. Scores and time to task completion were recorded, as well as self-reported difficulty, confidence and preference.ResultsNovice surgeons scored significantly higher in a test of anatomical orientation using three-dimensional compared to two-dimensional endoscopy (p < 0.001), with no significant difference in the speed of simulated endoscopic skills task completion. For both tasks, there was lower self-reported difficulty and increased confidence when using the three-dimensional endoscope. Participants preferred three-dimensional over two-dimensional endoscopy for both tasks.ConclusionThe findings demonstrate the superiority of three-dimensional endoscopy in anatomical orientation, specific to endoscopic ear surgery, with statistically indistinguishable performance in a skills task using a simulated trainer.
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Mahawongkajit, Prasit, Ajjana Techagumpuch, and Kharikarn Auksornchat. "Effects of basic endoscopic handling and care training on gastrointestinal endoscopy logistics." Endoscopy International Open 10, no. 01 (January 2022): E56—E61. http://dx.doi.org/10.1055/a-1630-6403.
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Abstract Background and study aims The current practice of endoscopists is undergoing a dramatic revolution due to emerging endoscopy practices. Increasing use of gastrointestinal endoscopy has led to hospital budgets setting aside funds specifically related to damage to endoscopic instruments. Therefore, training in understanding endoscopic equipment, handling techniques, and equipment care can be helpful in addressing this issue. The aim of this study was to investigate the effects of educational courses and training about basic endoscopic handling and care in gastrointestinal endoscopic care and services. Methods A number of new endoscopists, nurses, and nurse assistants were enrolled in a course for training in basic endoscopic handling and care. Data on the type of damage, cause, cost, and timing of endoscopic repair were prospectively collected. Data from the post-training period then were compared with retrospective data from the pre-training period. Results This study demonstrated that after training, there was less damage to endoscopes, lower costs associated with it, and repair times were shorter for endoscopes than before the training course. Post-training results indicated savings of a total of $ 40,617.21 or £ 29,539.78 and 102.6 days per damaged endoscope. Conclusions Basic endoscopic handling and care training plays an important role for both endoscopists and nurses, as well as in endoscopy facilities, specifically in avoiding the nuisance of unwanted and broken endoscopes. This could be beneficial for both hospital finances and endoscopic services.
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Uematsu, Junichi, Mitsushige Sugimoto, Mariko Hamada, Eri Iwata, Ryota Niikura, Naoyoshi Nagata, Masakatsu Fukuzawa, Takao Itoi, and Takashi Kawai. "Efficacy of a Third-Generation High-Vision Ultrathin Endoscope for Evaluating Gastric Atrophy and Intestinal Metaplasia in Helicobacter pylori-Eradicated Patients." Journal of Clinical Medicine 11, no. 8 (April 14, 2022): 2198. http://dx.doi.org/10.3390/jcm11082198.
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Background: Image-enhanced endoscopy methods such as narrow-band imaging (NBI) are advantageous over white-light imaging (WLI) for detecting gastric atrophy, intestinal metaplasia, and cancer. Although new third-generation high-vision ultrathin endoscopes improve image quality and resolution over second-generation endoscopes, it is unclear whether the former also enhances color differences surrounding atrophy and intestinal metaplasia for endoscopic detection. We compared the efficacy of a new third-generation ultrathin endoscope and an older second-generation endoscope. Methods: We enrolled 50 Helicobacter pylori-eradicated patients who underwent transnasal endoscopy with a second-generation and third-generation endoscope (GIF-290N and GIF-1200N, respectively) in our retrospective study. Color differences based on the International Commission on Illumination 1976 (L*, a*, b*) color space were compared between second-generation and third-generation high-vision endoscopes. Results: Color differences surrounding atrophy produced by NBI on the GIF-1200N endoscope were significantly greater than those on GIF-290N (19.2 ± 8.5 vs. 14.4 ± 6.2, p = 0.001). In contrast, color differences surrounding intestinal metaplasia using both WLI and NBI were similar on GIF-1200N and GIF-290N endoscopes. NBI was advantageous over WLI for detecting intestinal metaplasia on both endoscopes. Conclusions: NBI using a third-generation ultrathin endoscope produced significantly greater color differences surrounding atrophy and intestinal metaplasia in H. pylori-eradicated patients compared with WLI.
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Sivananthan, Arun, Ben Glover, Lakshmana Ayaru, Kinesh Patel, Ara Darzi, and Nisha Patel. "The evolution of lower gastrointestinal endoscopy: where are we now?" Therapeutic Advances in Gastrointestinal Endoscopy 13 (January 2020): 263177452097959. http://dx.doi.org/10.1177/2631774520979591.
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Lower gastrointestinal endoscopy has evolved over time, fulfilling a widening diagnostic and therapeutic remit. As our understanding of colorectal cancer and its prevention has improved, endoscopy has progressed with improved diagnostic technologies and advancing endoscopic therapies. Despite this, the fundamental design of the endoscope has remained similar since its inception. This review presents the important role lower gastrointestinal endoscopy serves in the prevention of colorectal cancer and the desirable characteristics of the endoscope that would enhance this. A brief history of the endoscope is presented. Current and future robotic endoscopic platforms, which may fulfil these desirable characteristics, are discussed. The incorporation of new technologies from allied scientific disciplines will help the endoscope fulfil its maximum potential in preventing the increasing global burden of colorectal cancer. There are a number of endoscopic platforms under development, which show significant promise.
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Lin, Xianqi, Zhenyi Zhang, Minzhao Gao, Zhenling Zhang, Zhidong Lin, Siwen Huang, Jiangnan Ren, et al. "Practical Experience of Endoscope Reprocessing and Working-Platform Disinfection in COVID-19 Patients: A Report from Guangdong China during the Pandemic." Gastroenterology Research and Practice 2020 (December 31, 2020): 1–4. http://dx.doi.org/10.1155/2020/9869742.
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Background. No consensus exists regarding which procedures should be performed to disinfect endoscopes and working platforms after COVID-19 patients have undergone endoscopy. Methods. We analyzed the disinfection quality of endoscopes and working platforms after 11 COVID-19 patients had undergone endoscopy. Conclusions. For endoscopic preprocessing at the bedside, a key disinfection step is using a multienzyme stock solution. The nucleic acid tests for endoscopists, washers, endoscopes, and working platforms were all negative. Based on our experience with the 11 COVID-19 patients who had undergone endoscopy, we provide an endoscopic reprocessing method for the bedside endoscopic diagnosis and treatment of COVID-19 patients for reference.
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Truitt, Theodore O., Roger A. Adelman, Dan H. Kelly, and J. Paul Willging. "Quantitative Endoscopy: Initial Accuracy Measurements." Annals of Otology, Rhinology & Laryngology 109, no. 2 (February 2000): 128–32. http://dx.doi.org/10.1177/000348940010900203.
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The geometric optics of an endoscope can be used to determine the absolute size of an object in an endoscopic field without knowing the actual distance from the object. This study explores the accuracy of a technique that estimates absolute object size from endoscopic images. Quantitative endoscopy involves calibrating a rigid endoscope to produce size estimates from 2 images taken with a known traveled distance between the images. The heights of 12 samples, ranging in size from 0.78 to 11.80 mm, were estimated with this calibrated endoscope. Backup distances of 5 mm and 10 mm were used for comparison. The mean percent error for all estimated measurements when compared with the actual object sizes was 1.12%. The mean errors for 5-mm and 10-mm backup distances were 0.76% and 1.65%, respectively. The mean errors for objects <2 mm and ≥2 mm were 0.94% and 1.18%, respectively. Quantitative endoscopy estimates endoscopic image size to within 5% of the actual object size. This method remains promising for quantitatively evaluating object size from endoscopic images. It does not require knowledge of the absolute distance of the endoscope from the object, rather, only the distance traveled by the endoscope between images.
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Lala Bekirova, Lala Bekirova, and Ravan Gambarov Ravan Gambarov. "INTELLIGENT BIOMEDICAL MEASUREMENT SYSTEM." INTERNATIONAL JOURNAL OF INNOVATIVE MEDICINE & HEALTHCARE 02, no. 01 (March 16, 2023): 49–54. http://dx.doi.org/10.55858/ijimh0201(04)2023-49.
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Early diagnosis of various diseases significantly improves survival. However, more than half of these cases are diagnosed late due to the high demand for colonoscopy - the "gold standard" of screening. Colonoscopy is limited by the outdated design of conventional endoscopes due to the high complexity and cost of use. Magnetic endoscopes are a promising alternative and overcome the cost disadvantages, but their translational phase is difficult to achieve because magnetic manipulations are complex and unintuitive. In this work, we use machine vision to develop an intelligent and autonomous endoscope control that allows non-expert users to efficiently perform in vivo magnetic colonoscopy. We combine the use of robotics, computer vision, and advanced control to offer an intuitive and efficient endoscopic system. Furthermore, we define the characteristics required to achieve autonomy in robotic endoscopy. The paradigm described here can be applied to a variety of applications requiring navigation in an unstructured environment, such as catheters, pancreatic endoscopy, bronchoscopy, and gastroscopy. This work brings alternative endoscopic technologies closer to the translational stage, increasing the availability of early disease treatment. Keywords: endoscope models, portable, capsule, mobile systems, mobile devices, picture completeness, modern technology
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Serdar Karaca, Ahmet, M. Mahir Özmen, Ahmet Çınar Yastı, and Seher Demirer. "Endoscopy in surgery." Turkish Journal of Surgery 37, no. 2 (June 1, 2021): 83–86. http://dx.doi.org/10.47717/turkjsurg.2021.000000576.
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In the last 20 years, there have been important developments in endoscopy. Initially, endoscopy was developed and used as a diagnostic tool. As new technology developed, these devices also became the basis for therapeutic maneuvers. In recent years, flexible endoscopes have been used to per- form procedures replacing traditional surgical approaches. Examples of this field are transanal minimally invasive surgery, natural orifice transluminal endoscopic surgery, endoscopic metabolic surgery and third space endoscopies. Throughout history, surgeons have played a vital role in the design and development of endoscopic techniques, procedures, and equipment. Surgeons continue to lead the advancement of endoscopy, make important contributions, and serve as role models for innovation.
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Lokhmatov, Maksim M., T. N. Budkina, V. I. Oldakovsky, A. V. Tupylenko, and S. I. Ibragimov. "INTRALUMINAL ENDOSCOPY IN CHILDREN - PAST, PRESENT, FUTURE." Russian Pediatric Journal 21, no. 4 (April 30, 2019): 230–36. http://dx.doi.org/10.18821/1560-9561-2018-21-4-230-236.
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The review presents the stages of the development of endoluminal endoscopy from rigid endoscopes with tube illumination to digital high-resolution endoscopy and methods of optical biopsy. The development of endoscopic studies in children began in the 60s of the XX century, and now they are indispensable methods of the visualization. There are described diagnostic options and achievements of intraluminal endoscopy in children, as well as the prospects for its development. The current level of endoscopy in pediatrics includes a high resolution of the obtained image, a morphological study of biopsies and a full range of endosurgical procedures. The authors believe the prospects for the development of endoluminal endoscopy in pediatrics to be determined by the improvement of endoscopes along with maintaining their high resolution with a gradual transition to robotic remote-controlled endoscopic systems.
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Jiang, Wei, Yuanyuan Zhou, Tao Yu, Xiao He, Lihua Peng, Yunsheng Yang, Zhidong Wang, and Hao Liu. "Interventional Status Awareness Based Manipulating Strategy for Robotic Soft Endoscopy." International Journal of Robotics and Automation Technology 6 (November 29, 2021): 1–10. http://dx.doi.org/10.31875/2409-9694.2019.06.1.
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Traditional soft endoscopy is operated with naked eyes and use of hands. Robotic soft endoscopy frees the hands of endoscopists, which reduces the labor-intensity and complexity of operation and improves the operational accuracy of endoscope, but it’s hardly to be reliably performed because the operator lacks of situational awareness of endoscopic interventional status when the hands are detached from the endoscope. This paper first presents a method to perceive the interventional status of endoscope based on image processing, the interventional status includes insertion length and velocity. A manipulating strategy was designed according to the perceived endoscope interventional status and construction parameters of dual robotic arms in order to achieve reliable interventional endoscopy. Human phantom experiments are carried out to verify the effectiveness and feasibility of the proposed interventional status awareness method and manipulating strategy. The results show that the robotic soft endoscopy can be well performed with the ability of interventional status awareness and coordinated manipulation of dual arms. The perceived insertion length indicates the position of the tip of endoscope in human body and the designed manipulating strategy is effective in endoscopic shape retention and torque transmission.
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Kim, Sang-Hyun, Hyuk-Soon Choi, Bora Keum, and Hoon-Jai Chun. "Robotics in Gastrointestinal Endoscopy." Applied Sciences 11, no. 23 (November 30, 2021): 11351. http://dx.doi.org/10.3390/app112311351.
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Recent advances in endoscopic technology allow clinicians to not only detect digestive diseases early, but also provide appropriate treatment. The development of various therapeutic endoscopic technologies has changed the paradigm in the treatment of gastrointestinal diseases, contributing greatly to improving the quality of life of patients. The application of robotics for gastrointestinal endoscopy improves the maneuverability and therapeutic ability of gastrointestinal endoscopists, but there are still technical limitations. With the development of minimally invasive endoscopic treatment, clinicians need more sophisticated and precise endoscopic instruments. Novel robotic systems are being developed for application in various clinical fields, to ultimately develop into minimally invasive robotic surgery to lower the risk to patients. Robots for endoscopic submucosal dissection, autonomous locomotive robotic colonoscopes, and robotic capsule endoscopes are currently being developed. In this review, the most recently developed innovative endoscopic robots were evaluated according to their operating mechanisms and purpose of use. Robotic endoscopy is an innovative treatment platform for future digestive endoscopy.
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Barbosa, Jackeline Maciel, Adenicía Custódia Silva Souza, Anaclara Ferreira Veiga Tipple, Fabiana Cristina Pimenta, Lara Stefania Netto de Oliveira Leão, and Silvia Rita Marin Caninni Silva. "Endoscope reprocessing using glutaraldehyde in endoscopy services of Goiânia, Brazil." Arquivos de Gastroenterologia 47, no. 3 (September 2010): 219–24. http://dx.doi.org/10.1590/s0004-28032010000300002.
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CONTEXT: The endoscopic procedure safety depends on the use of an adequately reprocessed device which quality is related to each of its operational steps. OBJECTIVE: To characterize the reprocessing of endoscopes using glutaraldehyde in endoscopy services METHODS: Study was conducted by observing the reprocessing of 60 endoscopes from 20 medical practices of the municipality of Goiânia, GO, central area of Brazil. RESULTS: This study showed failure in all reprocessing steps. The pre-washing was performed in 24 (40.0%) of the endoscope. In the cleaning steps, was identify the improper use of enzymatic detergent, and in 27 (45.0%) cases, the brushing of internal channels was not performed. All 60 endoscopes were submitted to this disinfectant. However, for 33 (55.0%) of the cases the internal channels was not filled. The total immersion of endoscope in the glutaraldehyde was not performed in 39 (65.0%) cases. The recommended minimum total immersion time for exposure to 2% glutaraldehyde solution was followed only for 12 (20.0%) endoscopes. There was no filter for water treatment used in the rinse of most endoscopes 54 (90.0%) and to dry the internal channels only 6 (10.0%) of them used compressed air. Adequate storing conditions were identified. CONCLUSION: Considering the particularities of the endoscope and its reprocessing, it is imperative to establish protocols to ensure the quality of the disinfection and the prevention of cross-contamination.
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Casini, Beatrice, Benedetta Tuvo, Fabrizio Maggi, Giuliana Del Magro, Alessandro Ribechini, Anna Laura Costa, Michele Totaro, Angelo Baggiani, Giulia Gemignani, and Gaetano Privitera. "COVID-19 Emergency Management: From the Reorganization of the Endoscopy Service to the Verification of the Reprocessing Efficacy." International Journal of Environmental Research and Public Health 17, no. 21 (November 4, 2020): 8142. http://dx.doi.org/10.3390/ijerph17218142.
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Microbiological surveillance carried out in order to verify the effectiveness of endoscope reprocessing does not include the research of viruses, although endoscopes may be associated with the transmission of viral infections. This paper reports the experience of the University Hospital of Pisa in managing the risk from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during an endoscopy. A review of the reprocessing procedure was conducted to assess whether improvement actions were needed. To verify the reprocessing efficacy, a virological analysis was conducted both before and after the procedure. Five bronchoscopes and 11 digestive endoscopes (6 gastroscopes and 5 colonoscopes) were sampled. The liquid samples were subjected to concentration through the use of the Macrosep Advance Centrifugal Devices (PALL Life Sciences, Port Washington, NY, USA) and subsequently analyzed using the cobas® SARS-CoV-2 Test (Roche Diagnostics, Basel, Switzerland), together with eSwab 490 CE COPAN swabs (COPAN, Brescia, Italy), which were used to sample surfaces. In accordance with the first ordinance regarding the coronavirus disease 2019 (COVID-19) emergency issued by the Tuscany Region in March 2020, a procedure dedicated to the management of the COVID-19 emergency in endoscopic practices was prepared, including the reprocessing of endoscopes. The virological analysis carried out on samples collected from endoscopes after reprocessing gave negative results, as well as on samples collected on the endoscopy column surfaces and the two washer-disinfectors that were dedicated to COVID-19 patients. The improvement in endoscope reprocessing implemented during the COVID-19 emergency was effective in ensuring the absence of SARS-CoV-2, thus reducing the risk of infections after an endoscopy on COVID-19 patients.
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Klironomos, G., O. Khan, A. Mansouri, J. Ebinu, L. Gonen, I. Radovanovic, and G. Zadeh. "A cadaveric study in endoscopic 3D visualization of posterior fossa neurovascular complexes." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 42, S1 (May 2015): S42—S43. http://dx.doi.org/10.1017/cjn.2015.193.
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Background: The use of 3D endoscopy for posterior fossa surgery gradually adopted. In this study we compare the 3D to classic 2D endoscopy in evaluating neurovascular complexes in posterior fossa. Methods: Twenty retrosigmoid craniotomies, with a maximal diameter of 2cm were performed under neuronavigation on 10 fresh cadaveric heads. The posterior fossa dura matter was opened with a C-shaped incision and the base of the dural flap was placed over the sigmoid sinus. We used 3D and 2D endoscopes, with 0 and 45 degree angulations, connected to high definition camera lenses for optimal visualization of posterior fossa structures. Results: The superior, middle and inferior neurovascular complexes of the cerebellopontine angle were better visualized with 3D comparing to 2D endoscope. A detailed view of the porus trigeminous and structures associated with the tentorial incisura was also attained with 3D endoscopy. Conclusion: The high quality and resolution obtained by 3D endoscopy makes it a potentially valuable surgical and teaching tool in the armamentarium for endoscopic posterior fossa surgery. The stereoscopic view of the critical neurovascular structures of the posterior fossa, offered by 3D images, allows for a more detailed dissection in the difficult area of the cerebellopontine angle.
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Kadayifci, Abdurrahman, Mustafa Atar, Serap Parlar, Ayhan Balkan, Irfan Koruk, and Mehmet Koruk. "Transnasal Endoscopy is Preferred by Transoral Endoscopy Experienced Patients." Journal of Gastrointestinal and Liver Diseases 23, no. 1 (March 1, 2014): 27–31. http://dx.doi.org/10.15403/jgld-1275.
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Background & Aims: Both unsedated transoral endoscopy (TOE) and sedated TOE have some drawbacks in clinical practice. Unsedated transnasal endoscopy (TNE) has been suggested as an alternative to both methods. This study aimed to determine the advantages of TNE in patients who have previously undergone unsedated conventional TOE.Methods: Patients who had received an unsedated TOE in the last 12 months and were scheduled for a second upper endoscopy were included. They were randomized to undergo either unsedated TOE, using a standard endoscope, or unsedated TNE, using an ultrathin endoscope. Post-procedure, patients were asked to complete a questionnaire to assess pain, discomfort and acceptability of the procedure, and to compare the current procedure with their previous unsedated TOE. Endoscope insertion rate, procedure duration, and side-effects were recorded.Results: Each group included 50 patients. With the exception of nasal pain, the tolerability and acceptance were significantly greater in the unsedated TNE group. Significantly more TNE patients (82%) found the current endoscopic procedure to be better than their previous TOE when compared with patients who had received a second TOE (12%). A repeat procedure was significantly more acceptable for TNE patients when compared to the TOE group (68% vs.16%). The duration of endoscopy was significantly shorter in TOE than in TNE (p<0.05). Endoscope insertion failed in 4% and mild epistaxis was observed in 4% of TNE patients.Conclusion: Unsedated TNE was better tolerated in endoscopy experienced patients when compared with unsedated TOE. The majority of patients found TNE more acceptable and preferable to TOE, suggesting that TNE should become a more common practice in clinics when applicable.
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Schroeder, Henry W. S., and Michael R. Gaab. "Intracranial endoscopy." Neurosurgical Focus 6, no. 4 (April 1999): E3. http://dx.doi.org/10.3171/foc.1999.6.4.4.
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The authors' intention is to reduce the invasiveness of intracranial procedures while avoiding traumatization of brain tissue, to decrease the risk of neurological and mental deficits. Intracranial endoscopy is a minimally invasive technique that provides rapid access to the target via small burr holes without the need for brain retraction. Craniotomy as well as microsurgical brain splitting and dissection can often be avoided. Furthermore, because obstructed cerebrospinal fluid pathways can be physiologically restored, the need for shunt placement is eliminated. The ventricular system and subarachnoid spaces provide ideal conditions for the use of an endoscope. Therefore, a variety of disorders, such as hydrocephalus, small intraventricular lesions, and arachnoid and parenchymal cysts can be effectively treated using endoscopic techniques. With the aid of special instruments, laser fibers, and bipolar diathermy, even highly vascularized lesions such as cavernomas may be treated. Moreover, during standard microsurgical procedures, the endoscopic view may provide valuable additional information ("looking around a corner") about the individual anatomy that is not visible with the microscope. In transsphenoidal pituitary surgery, transseptal dissection can be avoided if an endonasal approach is taken. In the depth of the intrasellar space, the extent of tumor removal can be more accurately controlled, especially in larger tumors with para- and suprasellar growth. The combined use of endoscopes and computerized neuronavigation systems increases the accuracy of the approach and provides real-time control of the endoscope tip position and approach trajectory. In the future, the indications for neuroendoscopy will certainly expand with improved technical equipment.
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Desai, Pankaj N., Chintan N. Patel, Mayank Kabrawala, Subhash Nanadwani, Rajiv Mehta, Ritesh Prajapati, Nisharg Patel, and Mohit Sethia. "Distal Endoscopic Attachments." Journal of Digestive Endoscopy 13, no. 04 (December 2022): 243–50. http://dx.doi.org/10.1055/s-0042-1755336.
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AbstractEndoscopy is an evolving science and the last two decades has seen it expand exponentially at a pace unapparelled in the past. With the advancement in new procedures like image-enhanced endoscopy, magnifying endoscopy, third space endoscopy, and highly advanced endoscopic ultrasound procedures, endoscopic accessories are also evolving to cater the unmet needs. Endoscopic cap or distal attachment cap is a simple but very important accessory in the endoscopists' armamentarium which has changed the path of endoscopic procedures. It has so far been used commonly mostly for variceal ligation and endoscopic mucosal resections for colorectal polyps. But the horizon of its use has expanded in the recent years for difficult clinical scenarios like providing stability to the endoscope, overcoming blind spots during screening colonoscopies, maintaining clear field of vision during endotherapy of gastrointestinal bleeding, and during magnification endoscopy for lesion characterizations and so on. These caps are of different shapes, sizes, colors, and material depending on manufacturers and their implications while performing varied endoscopies. This review summarizes the clinical utilities of the cap in diagnostic as well as therapeutic endoscopy and its expanding indications of use.
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Berkowitz, Shari Salzhauer. "Teaching Transnasal Endoscopy to Graduate Students Without a Hospital or Simulation Laboratory: Pool Noodles and Cadavers." American Journal of Speech-Language Pathology 26, no. 3 (August 15, 2017): 709–15. http://dx.doi.org/10.1044/2017_ajslp-15-0119.
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Purpose This study reports on a training opportunity in endoscopy in which speech-language pathology graduate students use inanimate objects and cadavers. Best practices for transnasal endoscopy in vivo require a physician to be nearby, but many graduate programs do not have this access. Method Endoscopy was offered as a graduate elective. Students (13 women) initially learned to manipulate the endoscope through the lumen of a swimming pool noodle that was embedded with trinkets. Endoscopic examination of inanimate objects became increasingly complex, followed by endoscopic examination of a cadaver. Results Pre- and postexamination measures and qualitative data from the 13 students revealed that students increased in confidence and in interest in this aspect of the field. All students met practical competencies for handling the endoscope, passing the endoscope on a narrow tube, and visualizing objects. Some students had the opportunity to pass the endoscope on a peer and did so successfully. Conclusion For programs with a cadaver lab available, this protocol offers an affordable option compared with purchasing a simulator. For those with neither a cadaver lab nor a simulation lab, passing the endoscope on inanimate objects alone is beneficial to student development and learning.
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Beilenhoff, Ulrike, Holger Biering, Reinhard Blum, Jadranka Brljak, Monica Cimbro, Jean-Marc Dumonceau, Cesare Hassan, et al. "Prevention of multidrug-resistant infections from contaminated duodenoscopes: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA)." Endoscopy 49, no. 11 (October 16, 2017): 1098–106. http://dx.doi.org/10.1055/s-0043-120523.
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Patients should be informed about the benefits and risks of endoscopic retrograde cholangiopancreatography (ERCP)Only specially trained and competent personnel should carry out endoscope reprocessing.Manufacturers of duodenoscopes should provide detailed instructions on how to use and reprocess their equipment.In the case of modifications to their equipment, manufacturers should provide updated instructions for use.Detailed reprocessing protocols based on the manufacturer’s instructions for use should clearly lay out the different reprocessing steps necessary for each endoscope model.Appropriate cleaning equipment should be used for duodenoscopes in compliance with the manufacturer’s instructions for use. Only purpose-designed, endoscope type-specific, single-use cleaning brushes should be used, to ensure optimal cleaning. As soon as the endoscope is withdrawn from the patient, bedside cleaning should be performed, followed by leak testing, thorough manual cleaning steps, and automated reprocessing, in order to:In addition to the leak test, visual inspection of the distal end as well as regular maintenance of duodenoscopes should be performed according to the manufacturer’s instructions for use, in order to detect any damage at an early stage.The entire reprocessing procedure in endoscope washer-disinfectors (EWDs) should be validated according to the European and International Standard, EN ISO 15883. Routine technical tests of EWDs should be performed according to the validation reports.Microbiological surveillance of a proportion of the department’s endoscopes should be performed every 3 months, with the requirement that all endoscopes used in the unit are tested at least once a year.In the case of suspected endoscopy-related infection, the relevant device (e. g., endoscope, EWD) should be taken out of service until adequate corrective actions have been taken. Outbreaks should be managed by a multidisciplinary team, including endoscopy, hygiene, and microbiology experts, manufacturers, and regulatory bodies, according to national standards and/or laws. In the case of suspected multidrug-resistant organism (MDRO) outbreaks, close cooperation between the endoscopy unit and the clinical health provider is essential (including infection control departments and hospital hygienists).
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Nardone, O. M., Y. Snir, J. Hodson, R. Cannatelli, N. Labarile, K. Siau, C. Hassan, et al. "DOP18 Advanced optical diagnosis technology for assessment of endoscopic and histological remission in Ulcerative Colitis: A systematic review and meta-analysis." Journal of Crohn's and Colitis 16, Supplement_1 (January 1, 2022): i067—i068. http://dx.doi.org/10.1093/ecco-jcc/jjab232.057.
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Abstract Background Advanced endoscopic technologies led to significant progress in the definition of endoscopic remission of ulcerative colitis (UC), and correlate better with histological changes, compared to standard endoscopy. However, whilst studies have assessed the diagnostic accuracy of endoscope technologies individually, there is current limited data comparing between technologies. As such, we aimed to compare the correlations between endoscopy and histology disease activity scores across endoscope technologies Methods We searched PubMed and Embase in January 2021 for eligible studies reporting the correlation between endoscopy and histology activity scores in UC. Studies were grouped by endoscope technology as standard-definition white light (SD-WLE), high-definition white light (HD-WLE), or electronic virtual chromoendoscopy (VCE), and comparisons made between these groups Results A total of N=27 studies were identified, of which N=12 were included in a meta-analysis of correlations between endoscopic and histological activity scores. Combining these returned a pooled correlation coefficient (rho) for the SD-WLE group of 0.61, which did not differ significantly from HD-WLE (rho: 0.79, p=0.140) or VCE (rho: 0.70, p=0.471) [Fig 1a]. In addition, N=4 studies reported the accuracy of endoscopic activity scores on WLE and VCE to diagnose histological remission. Pooling these found significantly higher accuracy for VCE, compared to WLE (risk ratio: 1.13, 95% CI: 1.07–1.19, p<0.001).[Fig 1b] Conclusion Activity scores assessed using endoscopy are strongly correlated with activity on histology. VCE appears to have better accuracy for the diagnosis of histological remission in UC, compared to WLE.
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Carniol, Eric T., Alejandro Vázquez, Tapan D. Patel, James K. Liu, and Jean Anderson Eloy. "Utility of Intraoperative Flexible Endoscopy in Frontal Sinus Surgery." Allergy & Rhinology 8, no. 2 (January 2017): ar.2017.8.0205. http://dx.doi.org/10.2500/ar.2017.8.0205.
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Background Surgical management of the frontal sinus can be challenging. Extensive frontal sinus pneumatization may form a far lateral or supraorbital recess that can be difficult to reach by conventional endoscopic surgical techniques, requiring extended approaches such as the Draf III (or endoscopic modified Lothrop) procedure. Rigid endoscopes may not allow visualization of these lateral limits to ensure full evacuation of the disease process. Methods Here we describe the utility of intraoperative flexible endoscopy in two patients with far lateral frontal sinus disease. Results In both cases, flexible endoscopy allowed confirmation of complete evacuation of pathologic material, thereby obviating more extensive surgical dissection. Conclusion In cases where visualization of the far lateral frontal sinus is inadequate with rigid endoscopes, flexible endoscopy can be used to determine the need for more extensive dissection.
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Shelkar, Ritesh, Jeevan Vedi, Seema Patel, KS Dasgupta, and Kanchan Lanjewar. "Role of Nasal Endoscopy in Sinonasal Diseases." An International Journal Clinical Rhinology 8, no. 1 (2015): 8–11. http://dx.doi.org/10.5005/jp-journals-10013-1220.
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ABSTRACT Aims and objectives To evaluate sinunasal diseases with the help of nasal endoscopy. To study efficacy of nasal endoscopy in diagnosing nasal pathology over clinical examination. To define medical and surgical functional endoscopic sinus surgery (FESS), management according to type of nasal pathology. To define applications of nasal endoscopy (biopsy, swab, epistaxis control, foreign body removal, rhinolith removal, follow-up). Materials and methods Total 100 patients were studied. Patients came with complaints of nasal blocking, nasal discharge, mass in nasal cavity, bleeding etc, included in study. Pre-endoscopic assessment was carried out like history, examination, investigation. Endoscopic was done after consent under necessary anesthesia. Endoscopy was done using 0 and 30° endoscope with three standard passes. Result Total 100 patients were studied. Male to female ratio was 1.8:1. Out of 100 patients maximum number of patients had chronic sinusitis on nasal endoscopy examination (22); followed by nasal polyp (27) and deviated nasal septum and epistaxis (10). Nasal endoscopy was an excellent diagnostic aid in condition like epistaxis, nasal mass, nasal obstruction, foreign body, nasopharyngeal tumor. Conclusion Diagnostic nasal endoscopy offers high diagnostic accuracy in patient with sinonasal complaints. Diagnostic nasal endoscopy is gold standard tool in patient having sinonasal complaints. It has high accuracy due to vision control, has less bleeding, minimal complication, and early postoperative recovery. It is a good tool for diagnosing anatomical variation. How to cite this article Shelkar R, Vedi J, Patel S, Dasgupta KS, Lanjewar K. Role of Nasal Endoscopy in Sinonasal Diseases. Clin Rhinol An Int J 2015;8(1):8-11.
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Nelson, Douglas B., William R. Jarvis, William A. Rutala, Amy E. Foxx-Orenstein, Gerald Isenberg, Georgia P. Dash, Carta J. Alvarado, et al. "Multi-society Guideline for Reprocessing Flexible Gastrointestinal Endoscopes." Infection Control & Hospital Epidemiology 24, no. 7 (July 2003): 532–37. http://dx.doi.org/10.1086/502237.
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The beneficial role of gastrointestinal endoscopy for the prevention, diagnosis, and treatment of many digestive diseases and cancer is well established. Like many sophisticated medical devices, the endoscope is a complex, reusable instrument that requires reprocessing before being used on subsequent patients. The most commonly used methods for reprocessing endoscopes result in high-level disinfection. To date, all published episodes of pathogen transmission related to gastrointestinal endoscopy have been associated with failure to follow established cleaning and disinfection/sterilization guidelines or use of defective equipment. Despite the strong published data regarding the safety of endoscope reprocessing, concern over the potential for pathogen transmission during endoscopy has raised questions about the best methods for disinfection or sterilization of these devices between patient uses.
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Nardone, Olga Maria, Yifat Snir, James Hodson, Rosanna Cannatelli, Nunzia Labarile, Keith Siau, Cesare Hassan, et al. "Advanced technology for assessment of endoscopic and histological activity in ulcerative colitis: a systematic review and meta-analysis." Therapeutic Advances in Gastroenterology 15 (January 2022): 175628482210925. http://dx.doi.org/10.1177/17562848221092594.
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Background: Advanced endoscopic technologies led to significant progress in the definition of endoscopic remission of ulcerative colitis (UC) and correlate better with histological changes, compared with standard endoscopy. However, while studies have assessed the diagnostic accuracy of endoscope technologies individually, there are currently limited data comparing between technologies. As such, the aim of this systematic review was to pool data from the existing literature and compare the correlations between endoscopy and histologic disease activity scores across endoscope technologies. Methods: We searched PubMed and Embase until February 2021 for eligible studies reporting the correlation between endoscopy and histology activity scores in UC. Studies were grouped by endoscope technology as standard-definition white light (SD-WLE), high-definition white light (HD-WLE) or electronic virtual chromoendoscopy (VCE) and comparisons made between these groups. Results: A total of N = 27 studies were identified, of which N = 12 were included in a meta-analysis of correlations between endoscopic and histological activity scores. Combining these studies identified considerable heterogeneity ( I2: 89–93%) and returned a pooled correlation coefficient ( ρ) for the SD-WLE group of 0.74, which did not differ significantly from HD-WLE ( ρ: 0.65, p = 0.521) or VCE ( ρ: 0.70, p = 0.801). In addition, N = 4 studies reported the accuracy of endoscopic activity scores on WLE and VCE to diagnose histological remission. Pooling these found significantly higher accuracy for VCE, compared with WLE [risk ratio: 1.13, 95% confidence interval (CI): 1.07–1.19, p < 0.001]. Conclusion: Activity scores assessed using endoscopy are strongly correlated with activity on histology regardless of endoscopic technology. VCE seems to be more accurate in predicting histological remission than WLE. However, given the heterogeneity between the included studies, head-to-head trials are warranted to confirm these findings.
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Sivananthan, Arun, Alexandros Kogkas, Ben Glover, Ara Darzi, George Mylonas, and Nisha Patel. "A novel gaze-controlled flexible robotized endoscope; preliminary trial and report." Surgical Endoscopy 35, no. 8 (May 24, 2021): 4890–99. http://dx.doi.org/10.1007/s00464-021-08556-1.
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Abstract Background Interventional endoluminal therapy is rapidly advancing as a minimally invasive surgical technique. The expanding remit of endoscopic therapy necessitates precision control. Eye tracking is an emerging technology which allows intuitive control of devices. This was a feasibility study to establish if a novel eye gaze-controlled endoscopic system could be used to intuitively control an endoscope. Methods An eye gaze-control system consisting of eye tracking glasses, specialist cameras and a joystick was used to control a robotically driven endoscope allowing steering, advancement, withdrawal and retroflexion. Eight experienced and eight non-endoscopists used both the eye gaze system and a conventional endoscope to identify ten targets in two simulated environments: a sphere and an upper gastrointestinal (UGI) model. Completion of tasks was timed. Subjective feedback was collected from each participant on task load (NASA Task Load Index) and acceptance of technology (Van der Laan scale). Results When using gaze-control endoscopy, non-endoscopists were significantly quicker when using gaze-control rather than conventional endoscopy (sphere task 3:54 ± 1:17 vs. 9:05 ± 5:40 min, p = 0.012, and UGI model task 1:59 ± 0:24 vs 3:45 ± 0:53 min, p < .001). Non-endoscopists reported significantly higher NASA-TLX workload total scores using conventional endoscopy versus gaze-control (80.6 ± 11.3 vs 22.5 ± 13.8, p < .001). Endoscopists reported significantly higher total NASA-TLX workload scores using gaze control versus conventional endoscopy (54.2 ± 16 vs 26.9 ± 15.3, p = 0.012). All subjects reported that the gaze-control had positive ‘usefulness’ and ‘satisfaction’ score of 0.56 ± 0.83 and 1.43 ± 0.51 respectively. Conclusions The novel eye gaze-control system was significantly quicker to use and subjectively lower in workload when used by non-endoscopists. Further work is needed to see if this would translate into a shallower learning curve to proficiency versus conventional endoscopy. The eye gaze-control system appears feasible as an intuitive endoscope control system. Hybrid gaze and hand control may prove a beneficial technology to evolving endoscopic platforms.
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Rückert, Jan, Philipp Lenz, Hauke Heinzow, Johannes Wessling, Tobias Warnecke, Ingo F. Herrmann, Michael Strahl, Frank Lenze, Tobias Nowacki, and Dirk Domagk. "Functional endoscopy in neurogenic dysphagia: a feasibility study focusing on the esophageal phase of swallowing." Endoscopy International Open 09, no. 04 (April 2021): E646—E652. http://dx.doi.org/10.1055/a-1380-3224.
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Abstract Background and study aims Due to demographic transition, neurogenic dysphagia has become an increasingly recognized problem. Patients suffering from dysphagia often get caught between different clinical disciplines. In this study, we implemented a defined examination protocol for evaluating the whole swallowing process by functional endoscopy. Special focus was put on the esophageal phase of swallowing. Patients and methods This prospective observational multidisciplinary study evaluated 31 consecutive patients with suspected neurogenic dysphagia by transnasal access applying an ultrathin video endoscope. Thirty-one patients with gastroesophageal reflux symptoms were used as a control group. We applied a modified approach including standardized endoscopic positions to compare our findings with fiberoptic endoscopic evaluation of swallowing and high-resolution manometry. The primary outcome measure was feasibility of functional endoscopy. Secondary outcome measures were adverse events (AEs), tolerability, and pathologic endoscopic findings. Results Functional endoscopy was successfully performed in all patients. No AEs were recorded. A variety of disorders were documented by functional endoscopy: incomplete or delayed closure of the upper esophageal sphincter in retroflex view, clearance disturbance of tubular esophagus, esophageal hyperperistalsis, and hypomotility. Analysis of results obtained with the diagnostic tools showed some discrepancies. Conclusions By interdisciplinary cooperation with additional assessment of the esophageal phase of deglutition using the innovative method of functional endoscopy, the diagnosis of neurogenic disorders including dysphagia may be significantly improved, leading to a better clinical understanding of complex dysfunctional patterns. To the best of our knowledge, this is the first study to show that a retroflex view of the ultrathin video endoscope within the esophagus can be safely performed. [NCT01995929]
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McLaughlin, Nancy, Amy A. Eisenberg, Pejman Cohan, Charlene B. Chaloner, and Daniel F. Kelly. "Value of endoscopy for maximizing tumor removal in endonasal transsphenoidal pituitary adenoma surgery." Journal of Neurosurgery 118, no. 3 (March 2013): 613–20. http://dx.doi.org/10.3171/2012.11.jns112020.
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Object Endoscopy as a visual aid (endoscope assisted) or as the sole visual method (fully endoscopic) is increasingly used in pituitary adenoma surgery. Authors of this study assessed the value of endoscopic visualization for finding and removing residual adenoma after initial microscopic removal. Methods Consecutive patients who underwent endoscope-assisted microsurgical removal of pituitary adenoma were included in this study. The utility of the endoscope in finding and removing residual adenoma not visualized by the microscope was noted intraoperatively. After maximal tumor removal under microscopic visualization, surgeries were categorized as to whether additional tumor was removed via endoscopy. Tumor removal and remission rates were also noted. Patients undergoing fully endoscopic tumor removal during this same period were excluded from the study. Results Over 3 years, 140 patients (41% women, mean age 50 years) underwent endoscope-assisted adenoma removal of 30 endocrine-active microadenomas and 110 macroadenomas (39 endocrine-active, 71 endocrine-inactive); 16% (23/140) of patients had prior surgery. After initial microscopic removal, endoscopy revealed residual tumor in 40% (56/140) of cases and the additional tumor was removed in 36% (50 cases) of these cases. Endoscopy facilitated additional tumor removal in 54% (36/67) of the adenomas measuring ≥ 2 cm in diameter and in 19% (14/73) of the adenomas smaller than 2 cm in diameter (p < 0.0001); additional tumor removal was achieved in 20% (6/30) of the microadenomas. Residual tumor was typically removed from the suprasellar extension and folds of the collapsed diaphragma sellae or along or within the medial cavernous sinus. Overall, 91% of endocrine-inactive tumors were gross-totally or near-totally removed, and 70% of endocrine-active adenomas had early remission. Conclusions After microscope-based tumor removal, endoscopic visualization led to additional adenoma removal in over one-third of patients. The panoramic visualization of the endoscope appears to facilitate more complete tumor removal than is possible with the microscope alone. These findings further emphasize the utility of endoscopic visualization in pituitary adenoma surgery. Longer follow-ups and additional case series are needed to determine if endoscopic adenomectomy translates into higher long-term remission rates.
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Zhang, Zhimin, Molly How Kue Bien, Lee Lai Chee, Nenny Suzanah Binte Sellamat, Chua Puay Hoon, Lai Kai Mun, and Ling Moi Lin. "SG-APSIC1058: Microbiological surveillance of endoscopes in a Singapore tertiary-care academic hospital: A retrospective study from 2018 to 2021." Antimicrobial Stewardship & Healthcare Epidemiology 3, S1 (February 2023): s31. http://dx.doi.org/10.1017/ash.2023.94.
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Objectives: Improper reprocessing of endoscopes may result in healthcare-associated infections. Regular microbiological surveillance is an important means of evaluating the quality of endoscope reprocessing. We evaluated the effectiveness of reprocessing endoscopes (including the protocols on steps to be taken in the event of any positive microbiological results) in a sterile supply unit (SSU) and an endoscopy unit in a Singapore tertiary-care academic hospital. Methods: Singapore General Hospital (SGH) is a 1,750-bed, tertiary-care, academic medical center in Singapore with 2 main SSUs: 1 inpatient endoscopy unit and 1 outpatient endoscopy unit. We reviewed microbiological surveillance results from endoscopes following reprocessing from January 2018 to December 2021. In total, 160 endoscopes (27 bronchoscopes, 58 gastroscopes, 52 colonoscopes, 6 duodenoscopes, 5 echoscopes, 5 cystoscopes, 5 rhinolaryngoscopes, and 5 enteroscopes) and 15 automated endoscope reprocessors (AERs) were evaluated for the presence of microorganisms. Samples were obtained by swabbing the tip of the scope and the biopsy channel. Fluid was flushed from the biopsy channel after reprocessing, and this water from the AERs was sampled after waterline disinfection. Results: Of the 15,783 samples collected, 15,667 (99.3%) yielded no growth; 36 (0.2%) were positive for gut and environmental flora; and 80 (0.5%) were positive for low-concern organisms such as skin flora. Conclusions: Microbiological surveillance yielded a high percentage of negative results confirming the effectiveness of endoscope reprocessing. This quality-assurance process is necessary and beneficial in achieving patient safety.
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Nishizawa, Toshihiro, Kosuke Sakitani, Hidekazu Suzuki, Tadahiro Yamakawa, Yoshiyuki Takahashi, Shuntaro Yoshida, Yousuke Nakai, et al. "Small-caliber endoscopes are more fragile than conventional endoscopes." Endoscopy International Open 07, no. 12 (December 2019): E1729—E1732. http://dx.doi.org/10.1055/a-1036-6186.
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Abstract Background and study aims The repair costs of gastrointestinal endoscopes account for a significant proportion of the total budget of an endoscopy unit. This study evaluated the repair costs of small-caliber endoscopes and conventional endoscopes used in esophagogastroduodenoscopy (EGD). Patients and methods A retrospective analysis of upper gastrointestinal endoscope damage and repair costs between April 2012 and May 2019 was performed at the Toyoshima Endoscopy Clinic. Conventional endoscopes (GIF-H260, GIF-HQ290, and GIF-H290Z) were used for transoral EGD while small-caliber endoscopes (GIF-XP260N and GIF-XP290N) were used for transnasal or transoral EGD. Results Three small-caliber endoscopes and five conventional endoscopes were used for 1,031 procedures and 31,192 procedures, respectively. The number of procedures/damage incidence for small-caliber endoscope and conventional endoscopes was 344 and 1950, respectively. Damage incidence for small-caliber endoscopes was significantly higher than for conventional endoscopes (P = 0.014). Repair costs/procedure were $ 5.95 ± $132 for small-caliber endoscopes and $2.41 ± $115 for conventional endoscopes. Repair costs/procedure for small-caliber endoscopes were more than twice those for conventional endoscopes. Conclusions Small-caliber endoscopes are more fragile than conventional endoscopes.
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Badr-El-Dine, Mohammed, Yasser G. Shewel, Ahmad A. Ibrahim, and Mohammed Khalifa. "Endoscope-assisted surgery: a major adjunct in cholesteatoma surgery." Egyptian Journal of Otolaryngology 29, no. 2 (April 2013): 66–70. http://dx.doi.org/10.7123/01.ejo.0000426391.27924.84.
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EnAbstract Objective The purpose of this study was to evaluate the role of middle-ear endoscopy in the effective control over cholesteatoma through visualizing hidden areas of the middle-ear cleft. Materials and methods A total of 60 ears with retraction pocket cholesteatoma were operated upon. They were subdivided into 40 cases operated upon using the canal wall up technique and another 20 cases operated upon using transcanal atticotomy. Endoscopically guided ear surgery was incorporated complementary to the microscope as a principal part in the procedure. Results The incidence of cholesteatoma in the facial recess that was visualized by the endoscope was 25% compared with 20% by the microscope, whereas the incidence of detection of cholesteatoma in the sinus tympani by the endoscope was 35% compared with 5% by the microscope. Cholesteatoma in the anterior epitympanic recess was detected by the endoscope in 10% of ears compared with 0% by the microscope. In this series, no morbidity or complication was encountered secondary to the use of endoscopes in the mastoid or the middle ear. Conclusion Endoscope-assisted ear surgery has many benefits in cholesteatoma surgery as endoscopy helps explore hidden areas of the middle-ear cavity with a much lesser requirement for surgical exposure and the need to drill healthy bone; therefore, effective control over the disease can be achieved, thus establishing the concept of functional endoscopic ear surgery.
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Saviuc, Philippe, Romain Picot-Guéraud, Jacqueline Shum Cheong Sing, Pierre Batailler, Isabelle Pelloux, Marie-Pierre Brenier-Pinchart, Valérie Dobremez, and Marie-Reine Mallaret. "Evaluation of the Quality of Reprocessing of Gastrointestinal Endoscopes." Infection Control & Hospital Epidemiology 36, no. 9 (May 29, 2015): 1017–23. http://dx.doi.org/10.1017/ice.2015.123.
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OBJECTIVESTo evaluate the quality of gastrointestinal endoscope reprocessing and discuss the advantages of microbiological surveillance testing of these endoscopes.METHODSRetrospective analysis of the results of endoscope sampling performed from October 1, 2006, through December 31, 2014, in a gastrointestinal endoscopy unit of a teaching hospital equipped with 89 endoscopes and 3 automated endoscope reprocessors, with an endoscopy quality assurance program in place. The compliance rate was defined as the proportion of the results classified at target or alert levels according to the French guidelines. A multivariate analysis (logistic regression) was used to identify the parameters influencing compliance.RESULTSA total of 846 samples were taken. The overall compliance rate was 86% and differed significantly depending on the sampling context (scheduled or not scheduled), the type of endoscope, and the season. No other parameter was associated with compliance. A total of 118 samples carried indicator microorganisms such as Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Enterobacteriaceae, and Candida sp.CONCLUSIONThe systematic use of an automated endoscope reprocessor does not provide totally satisfactory compliance. Microbiological surveillance is indispensable to monitor reprocessing, reinforce good practices (endoscopes, reprocessing units), and detect endoscopes requiring early technical maintenance.Infect. Control Hosp. Epidemiol. 2015;36(9):1017–1023
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Luo, Xiongbiao, Kensaku Mori, and Terry M. Peters. "Advanced Endoscopic Navigation: Surgical Big Data, Methodology, and Applications." Annual Review of Biomedical Engineering 20, no. 1 (June 4, 2018): 221–51. http://dx.doi.org/10.1146/annurev-bioeng-062117-120917.
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Interventional endoscopy (e.g., bronchoscopy, colonoscopy, laparoscopy, cystoscopy) is a widely performed procedure that involves either diagnosis of suspicious lesions or guidance for minimally invasive surgery in a variety of organs within the body cavity. Endoscopy may also be used to guide the introduction of certain items (e.g., stents) into the body. Endoscopic navigation systems seek to integrate big data with multimodal information (e.g., computed tomography, magnetic resonance images, endoscopic video sequences, ultrasound images, external trackers) relative to the patient's anatomy, control the movement of medical endoscopes and surgical tools, and guide the surgeon's actions during endoscopic interventions. Nevertheless, it remains challenging to realize the next generation of context-aware navigated endoscopy. This review presents a broad survey of various aspects of endoscopic navigation, particularly with respect to the development of endoscopic navigation techniques. First, we investigate big data with multimodal information involved in endoscopic navigation. Next, we focus on numerous methodologies used for endoscopic navigation. We then review different endoscopic procedures in clinical applications. Finally, we discuss novel techniques and promising directions for the development of endoscopic navigation.
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Baazil, A. H. A., J. G. G. Dobbe, E. van Spronsen, F. A. Ebbens, F. G. Dikkers, G. J. Streekstra, and M. J. F. de Wolf. "A volumetric three-dimensional evaluation of invasiveness of an endoscopic and microscopic approach for transmeatal visualisation of the middle ear." Journal of Laryngology & Otology 135, no. 5 (April 22, 2021): 410–14. http://dx.doi.org/10.1017/s0022215121000293.
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AbstractObjectiveThis study aimed to compare the necessary scutum defect for transmeatal visualisation of middle-ear landmarks between an endoscopic and microscopic approach.MethodHuman cadaveric heads were used. In group 1, middle-ear landmarks were visualised by endoscope (group 1 endoscopic approach) and subsequently by microscope (group 1 microscopic approach following endoscopy). In group 2, landmarks were visualised solely microscopically (group 2 microscopic approach). The amount of resected bone was evaluated via computed tomography scans.ResultsIn the group 1 endoscopic approach, a median of 6.84 mm3 bone was resected. No statistically significant difference (Mann–Whitney U test, p = 0.163, U = 49.000) was found between the group 1 microscopic approach following endoscopy (median 17.84 mm3) and the group 2 microscopic approach (median 20.08 mm3), so these were combined. The difference between the group 1 endoscopic approach and the group 1 microscopic approach following endoscopy plus group 2 microscopic approach (median 18.16 mm3) was statistically significant (Mann–Whitney U test, p < 0.001, U = 18.000).ConclusionThis study showed that endoscopic transmeatal visualisation of middle-ear landmarks preserves more of the bony scutum than a microscopic transmeatal approach.
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KORCZEWSKI, Zbigniew. "Measurement methods in marine engine endoscopy." Combustion Engines 133, no. 2 (May 1, 2008): 3–19. http://dx.doi.org/10.19206/ce-117241.
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The paper presents selected metrological techniques that may be applied in diagnostic endoscopy in complex machinery including turbine and piston marine engines. The evolution of contemporary endoscopes has been described as well as theoretical background for optical and digital endoscopy. The methods of surface defect measurements of selected elements of marine engine structure have been presented based on a digital recording of endoscopic images: Stereo Probe, Shadow Probe, laser method and RGB.
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Ota, Kazuhiro, Yuichi Kojima, Kazuki Kakimoto, Sadaharu Nouda, Toshihisa Takeuchi, Yasunori Shindo, Yoshitake Ohtsuka, Naotake Ohtsuka, and Kazuhide Higuchi. "Safety, efficacy, and maneuverability of a self-propelled capsule endoscope for observation of the human gastrointestinal tract." Endoscopy International Open 09, no. 09 (August 23, 2021): E1391—E1396. http://dx.doi.org/10.1055/a-1507-4540.
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Abstract Background and study aims We developed a self-propelled capsule endoscope that can be controlled from outside the body with real-time observation. To improve the device, we conducted a clinical trial of total gastrointestinal capsule endoscopy in healthy subjects to ascertain whether our first-generation, self-propelled capsule endoscope was safe and effective for observing the entire human gastrointestinal tract. Patients and methods After adequate gastrointestinal pretreatment, five healthy subjects were instructed to swallow a self-propelling capsule endoscope and the safety of a complete gastrointestinal capsule endoscopy with this device was assessed. We also investigated basic problems associated with complete gastrointestinal capsule endoscopy. Results No adverse effects of the magnetic field were identified in any of the subjects. No mucosal damage was noted in any of the subjects with the use of our first-generation, self-propelling capsule endoscope. We found that it took longer than expected to observe the stomach; the view was compromised by the swallowed saliva. The pylorus was extremely difficult to navigate, and the endoscope’s fin sometimes got caught in the folds of the small intestine and colon. Conclusions To resolve the problems associated with the existing self-propelling capsule endoscope, it may be necessary to not only improve the capsule endoscopes, but also to control the environment within the gastrointestinal tract with medications and other means. Our results could guide other researchers in developing capsule endoscopes controllable from outside the body, thus allowing real-time observation.
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Muthiah, Karuppan Chetty, Robert Enns, David Armstrong, Angela Noble, James Gray, Paul Sinclair, Palma Colacino, and Harminder Singh. "A Survey of the Practice of After-Hours and Emergency Endoscopy in Canada." Canadian Journal of Gastroenterology 26, no. 12 (2012): 871–76. http://dx.doi.org/10.1155/2012/951071.
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OBJECTIVE: To determine staffing and practice patterns for after-hours endoscopy service in CanadaMETHODS: A link to a web-based survey was sent by e-mail to all clinical members of the Canadian Association of Gastroenterology in February 2011. A priori, it was planned to compare variations in practice among gastroenterologists (GIs) performing endoscopy in different regions of Canada, between pediatric and adult GIs, and between university and community hospitals.RESULTS: Of 422 potential respondents, 168 (40%) responded. Of the 139 adult GIs, 61% performed after-hours endoscopy in the endoscopy suite where daytime procedures were performed, 62% had a trained endoscopy nurse available for all procedures, 38% had access to propofol sedation, 12% reprocessed the endoscopes themselves or with the help of a resident, 4% had out-of-hospital patients come directly to their endoscopy suite and 53% were highly satisfied. The adult endoscopists practising at community hospitals were more likely to have an anesthetist attend the procedure. Regional differences were noted, with more involvement of anesthetists (13%) and availability of propofol (50%) in Ontario, more frequent reprocessing of endoscopes in the central reprocessing units in British Columbia (78%) and almost universal availability of a trained endoscopy nurse (96%) with concomitant higher endoscopist satisfaction (84% highly satisfied) in Alberta.CONCLUSIONS: More than one-third of surveyed endoscopists across the country do not have a trained endoscopy nurse to assist in after-hours endoscopy – the time period when urgent patients often present and typically require therapeutic endoscopic interventions. There are significant regional differences in the practice of after-hours endoscopy in Canada.
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Beilenhoff, Ulrike, Holger Biering, Reinhard Blum, Jadranka Brljak, Monica Cimbro, Jean-Marc Dumonceau, Cesare Hassan, et al. "Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA) – Update 2018." Endoscopy 50, no. 12 (November 20, 2018): 1205–34. http://dx.doi.org/10.1055/a-0759-1629.
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AbstractThis Position Statement from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology Nurses and Associates (ESGENA) sets standards for the reprocessing of flexible endoscopes and endoscopic devices used in gastroenterology. An expert working group of gastroenterologists, endoscopy nurses, chemists, microbiologists, and industry representatives provides updated recommendations on all aspects of reprocessing in order to maintain hygiene and infection control.
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Tanaka, Tatsuya, Hirofumi Goto, Nobuaki Momozaki, and Eiichiro Honda. "Endoscopic hematoma evacuation for acute subdural hematoma with improvement of the visibility of the subdural space and postoperative management using an intracranial pressure sensor." Surgical Neurology International 14 (January 6, 2023): 1. http://dx.doi.org/10.25259/sni_1084_2022.
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Background: The first choice to treat acute subdural hematoma (ASDH) is large craniotomy under general anesthesia. However, increasing age or the comorbid burden of patients may render invasive treatment strategy inappropriate. These medically frail patients with ASDH may benefit from a combination of small craniotomy and endoscopic hematoma removal, which is less invasive. We proposed covering with protective sheets to prevent brain injury due to contact with the endoscope and suction cannula and improve visualization of the subdural space. Moreover, we placed an intracranial pressure (ICP) sensor after endoscopic hematoma removal. In this article, we attempted to clarify the use of small craniotomy evacuation with endoscopy for ASDH. Methods: Between January 2015 and December 2019, nine patients with ASDH underwent hematoma evacuation with endoscopy at our hospital. ASDH was removed using a suction tube with the aid of a rigid endoscope through the small craniotomy (5–6 cm). Improvement of the clinical symptoms and procedure-related complications was evaluated. Results: No procedure-related hemorrhagic complications were observed. The outcomes of our endoscopic surgery were satisfactory without complications or rebleeding. The outcomes were not inferior to those of other reported endoscopic surgeries. Conclusion: The results suggest that small craniotomy evacuation with endoscopy and postoperative management using an ICP sensor is a safe, effective, and minimally invasive treatment approach for ASDH in appropriately selected cases.
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Rai, Praveer. "Disinfection of Endoscopy and Reusability of Accessories." Journal of Digestive Endoscopy 11, no. 01 (March 2020): 61–66. http://dx.doi.org/10.1055/s-0040-1712238.
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AbstractCorona viruses are a group of medium-sized positive-sense single-stranded RNA viruses with crown-like structure due to projections noted over the surface of the virus. The infection has been declared as a pandemic by the world health organization (WHO) in March 2020. Health care professionals in endoscopy are at high risk of infection by novel corona virus disease 2019 (COVID-19) from inhalation of droplets, conjunctival contact, feces, and touch contamination. Upper gastrointestinal (GI) endoscopy is considered to be a high-risk aerosol-generating procedures (AGPs) and the live virus has been found in patient stool. Flexible endoscopes when contaminated have been considered as the vector for transmission of infections. Infections related to the side viewing endoscopes and endoscopic ultrasound scopes are more frequent than upper GI scope and colonoscopes. Stratifying patients needing endoscopy and deferral of elective procedures will help to decrease the virus spread. Planning and revision of workflows is necessary for safety of patient and staff and to successfully provide infection prevention and control measures, for this a “three zones and two passages” concept should be followed. Manual cleaning followed by high-level disinfection (HLD), effectively eliminates nearly all microorganisms from endoscopes during reprocessing. Transmission of viral infections during endoscopy is quite rare and, it is usually the result of noncompliance from the essential steps of reprocessing. Reuse of any disposable GI endoscopic device is strongly discouraged. Environmental decontamination is essential to reduce the risk of fomite transmission. Noncritical environmental surfaces frequently touched by hands (e.g., bedside tables and bed rails) and endoscopy furniture and floor should be considered heavily contaminated in patients with intermediate or high risk of COVID-19 and should be thoroughly disinfected at the end of each procedure. If available, negative pressure rooms are preferred for endoscopy, as has been advised by Centers for Disease Control and Prevention (CDC). Staff involved in reprocessing and the cleaning of endoscopy rooms should utilize personal protective equipment (PPE) including N95 mask. Reprocessing staff should undergo necessary training and ongoing annual assessment of competency.
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Iskandar, Bermans, and Ricardo de Amoreira Gepp. "Shunt malfunction and endoscopy." Archives of Pediatric Neurosurgery 3, no. 1(January-April) (January 22, 2021): e792021. http://dx.doi.org/10.46900/apn.v3i1(january-april).79.
Full textAbstract:
Objective:
Hydrocephalus is the most common neurological disease in pediatric neurosurgery.(1) The CSF shunts remains as the most common treatment choice for nonobstructive hydrocephalus worldwide, but shunt complications still the most common neurosurgical problem, especially in pediatric neurosurgery. Endoscopy and shunts are the way to treat hydrocephalus. Especially third ventriculostomy is the most effective treatment to obstructive hydrocephalus but shunt still the most important way to treat.(2, 3) Shunt malfunction is frequent and after so many years this is very important problem to the patients. Ventricular problem due to obstruction is responsible up to 72% of shunt problems.(4) The Shunt Trial Study showed that the overall shunt survival was 62% at 1 year, 52% at 2 years, 46% at 3 years, 41% at 4 years. The survival curves for the 3 differents valves were similar to those from the original trial and did not show a survival advantage for any particular valve.(5, 6) We still don´t have one perfect solution to hydrocephalus and shunt malfunction.
The major author described his experience in use endoscopy to evaluate and treat shunt malfunction and one new approach and way to evaluate this problem.
Results/Discussion:
The literature review was performed, and we found 84 articles when we used the keywords. Endoscopy has been one important way to treat and solve shunt problems. In obstructive hydrocephalus third ventriculostomy is the best way to treat these patients.(1-3)
The major author first described goals of endoscopy. First goal is safe catheter removal in surgical review, avoiding bleeding when removing catheter addressing all the adhesions on catheter. Second goal is put in optimal position the new catheter with pure endoscopy view or using neuronavigation systems that could help the endoscope system.(7, 8)
Optimal new catheter placement and optimal long-term catheter survival are especially important because most of the problems are due to ventricular problems. These good placements could avoid loculations and ventricular collapse with ependymal problems. Avoid new catheter malpositiitioning, you can use the endoscope to follow the old tract to insert the new catheter in one good position avoiding choroid plexus. Another situation is when you have small ventricles especially in slit ventricle syndrome.
The major author has been studied some causes to ventricular catheter obstruction. He noticed after some surgical reviews some ventricular ependymal inside catheter. Ventricular ependymal protrusions inside the catheter could cause intermittent occlusion.(8) Some endoscope views showed these protrusion and ependymal changes after intermittent increase and decrease of ventricular pressure. These protrusions correspond to catheter holes a secondary to suction. These protrusions could stuck in the holes in chronicle suction.(8) The major author reported one endoscopic evidence of overdrainage-related ventricular tissue protrusions that cause partial or complete obstruction of the ventricular catheter. He did a retrospective review in fifty patients underwent 83 endoscopic shunt revision procedures that revealed in-growth of ventricular wall tissue into the catheter tip orifices (ependymal bands), producing partial, complete, or intermittent shunt obstructions. Endoscopic ventricular explorations revealed ependymal bands at various stages of development, which appear to form secondarily to siphoning.(8)
How to minimize this overshunting? Anti siphon systems could help and decrease proximal shunt malfunction in some complex patients. The other problem is ventricular bleeding. The use of endoscope has been important tool to remove ventricular catheters, when you could see the adhesions.(9)
The use the endoscope could be particularly important to open loculations and cysts avoiding ventricular entrapment. Patients with ventricular cysts could need more than one catheter. The use of endoscopy to fenestrate the cyst could keep the patient with one catheter or without any shunt system.(10, 11)
Conclusion:
Shunt malfunction has a lot of possible causes, but a probably ventricular catheter problem is the most common situation. Choose appropriate endoscope rigid or flexible for each case could help to treat and avoid some of ventricular. Endoscopy could be one important tool to help the surgeon to understand and solve this dangerous situation to the patient. Ventricular wall protrusions are a significant cause of proximal shunt obstruction, and they appear to be caused by siphoning of surrounding tissue into the ventricular catheter orifices.
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Boese, Axel, Cora Wex, Roland Croner, Uwe Bernd Liehr, Johann Jakob Wendler, Jochen Weigt, Thorsten Walles, et al. "Endoscopic Imaging Technology Today." Diagnostics 12, no. 5 (May 18, 2022): 1262. http://dx.doi.org/10.3390/diagnostics12051262.
Full textAbstract:
One of the most applied imaging methods in medicine is endoscopy. A highly specialized image modality has been developed since the first modern endoscope, the “Lichtleiter” of Bozzini was introduced in the early 19th century. Multiple medical disciplines use endoscopy for diagnostics or to visualize and support therapeutic procedures. Therefore, the shapes, functionalities, handling concepts, and the integrated and surrounding technology of endoscopic systems were adapted to meet these dedicated medical application requirements. This survey gives an overview of modern endoscopic technology’s state of the art. Therefore, the portfolio of several manufacturers with commercially available products on the market was screened and summarized. Additionally, some trends for upcoming developments were collected.
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Xu, Xinghua, Xiaolei Chen, Fangye Li, Xuan Zheng, Qun Wang, Guochen Sun, Jun Zhang, and Bainan Xu. "Effectiveness of endoscopic surgery for supratentorial hypertensive intracerebral hemorrhage: a comparison with craniotomy." Journal of Neurosurgery 128, no. 2 (February 2018): 553–59. http://dx.doi.org/10.3171/2016.10.jns161589.
Full textAbstract:
OBJECTIVEThe goal of this study was to investigate the effectiveness and practicality of endoscopic surgery for treatment of supratentorial hypertensive intracerebral hemorrhage (HICH) compared with traditional craniotomy.METHODSThe authors retrospectively analyzed 151 consecutive patients who were operated on for treatment of supratentorial HICH between January 2009 and June 2014 in the Department of Neurosurgery at Chinese PLA General Hospital. Patients were separated into an endoscopy group (82 cases) and a craniotomy group (69 cases), depending on the surgery they received. The hematoma evacuation rate was calculated using 3D Slicer software to measure the hematoma volume. Comparisons of operative time, intraoperative blood loss, Glasgow Coma Scale score 1 week after surgery, hospitalization time, and modified Rankin Scale score 6 months after surgery were also made between these groups.RESULTSThere was no statistically significant difference in preoperative data between the endoscopy group and the craniotomy group (p > 0.05). The hematoma evacuation rate was 90.5% ± 6.5% in the endoscopy group and 82.3% ± 8.6% in the craniotomy group, which was statistically significant (p < 0.01). The operative time was 1.6 ± 0.7 hours in the endoscopy group and 5.2 ± 1.8 hours in the craniotomy group (p < 0.01). The intraoperative blood loss was 91.4 ± 93.1 ml in the endoscopy group and 605.6 ± 602.3 ml in the craniotomy group (p < 0.01). The 1-week postoperative Glasgow Coma Scale score was 11.5 ± 2.9 in the endoscopy group and 8.3 ± 3.8 in the craniotomy group (p < 0.01). The hospital stay was 11.6 ± 6.9 days in the endoscopy group and 13.2 ± 7.9 days in the craniotomy group (p < 0.05). The mean modified Rankin Scale score 6 months after surgery was 3.2 ± 1.5 in the endoscopy group and 4.1 ± 1.9 in the craniotomy group (p < 0.01). Patients had better recovery in the endoscopy group than in the craniotomy group. Data are expressed as the mean ± SD.CONCLUSIONSCompared with traditional craniotomy, endoscopic surgery was more effective, less invasive, and may have improved the prognoses of patients with supratentorial HICH. Endoscopic surgery is a promising method for treatment of supratentorial HICH. With the development of endoscope technology, endoscopic evacuation will become more widely used in the clinic. Prospective randomized controlled trials are needed.
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Xu, Y., R. Chen, P. Zhang, L. Chen, B. Luo, Y. Li, X. Xiao, and W. Dong. "A REVIEW OF MAGNETIC SENSOR-BASED POSITIONING TECHNIQUES FOR CAPSULE ENDOSCOPY." International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences XLVI-3/W1-2022 (April 22, 2022): 219–26. http://dx.doi.org/10.5194/isprs-archives-xlvi-3-w1-2022-219-2022.
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Abstract. The capsule endoscope, as one of important equipment in screening the entire spectrum of digestive tract disease diagnosis, has largely compensated for the limited of vision field and poor patient experience of wired endoscopes. In order to better develop the clinical application of capsule endoscope and assist doctors in the diagnosis and treatment of gastrointestinal diseases, there is an urgent need to solve a key scientific problem, that is obtaining the position information of capsule endoscope in the body. This article reviews the research evolution of the capsule endoscope based on magnetic localization through the last 10 years and describes notable problem, as well as technological challenges to overcome. Besides that, the article also presents the future development in capsule endoscopy localization technology based on magnetic sensors, for further developing capsule endoscopy localization and surgical navigation.
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Peris-Celda, Maria, Leila Da Roz, Alejandro Monroy-Sosa, Takashi Morishita, and Albert L. Rhoton. "Surgical Anatomy of Endoscope-Assisted Approaches to Common Aneurysm Sites." Operative Neurosurgery 10, no. 1 (November 13, 2013): 121–44. http://dx.doi.org/10.1227/neu.0000000000000205.
Full textAbstract:
Abstract BACKGROUND: The endoscope is being introduced as an adjuvant to improve visualization of certain areas in open cranial surgery. OBJECTIVE: To describe the endoscopic anatomy of common aneurysm sites and to compare it with the microsurgical anatomy. METHODS: Pterional, anterior interhemispheric, and subtemporal approaches to the most common aneurysm sites were examined in cadaveric heads under the surgical microscope and with the endoscope. RESULTS: The endoscopic view, particularly with the angled endoscopes, provides a significant improvement compared with the microscopic view, especially for poorly visualized sites such as the medial aspect of the supraclinoid carotid artery and its branches, the area below the anterior perforated substance and optic tract, and the carotid and basilar bifurcations. The endoscope aided in the early visualization of perforating branches at each aneurysm site except the middle cerebral artery. Small-diameter optics (2.7 mm) provided greater space for dissection and less potential for tissue damage in narrow places, whereas the larger 4-mm diameter optics provided better visualization and less panoramic distortion. The positioning of the endoscope for each aneurysm site is reviewed. CONCLUSION: The endoscope provides views that complement or improve the microscopic view at each aneurysm site except the middle cerebral artery. Endoscopy training and a thorough knowledge of endoscopic vascular anatomy are essential to safely introduce endoscopic assistance in vascular surgery.
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Sweigert, Patrick, Adam Van Huis, Eric Marcotte, and Bipan Chand. "Flexible Endoscopy: The Fundamentals." Digestive Disease Interventions 02, no. 04 (December 2018): 289–98. http://dx.doi.org/10.1055/s-0038-1675754.
Full textAbstract:
Endoscopy highlights the intersection of technological advancements and medical application. Innovation in optics, illumination, imaging, and manufacturing has allowed for the development of a complex array of instruments for use by endoscopists. Flexible gastrointestinal (GI) endoscopy has emerged to become a well-established minimally invasive aspect of prevention, diagnosis, and treatment of GI disease.Flexible endoscopes and their associated instruments and platforms are described, acknowledging that such lists are dynamic. The procedure environment is also described in terms of location, equipment, ergonomics, personnel involved, and recovery considerations.Recommendations from GI and anesthesiology associations are outlined to summarize current practices in the administration of sedative drugs to reduce patient discomfort, allow for a technically successful procedure, and reduce patient memory of the procedure.The training process for GI endoscopy is described for general surgery residents and GI fellows. Training involves didactic and technical curriculum along with mentor-supervised endoscopic procedures. After the completion of training, residents and fellows proceed through a credentialing process, which culminates in granting privileges to an individual to perform GI endoscopic procedures. Once in practice, providers must stay up to date on the ever-changing world of medical documentation, coding, and billing to ensure appropriate reimbursement.
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Al-Ameri, Laith Thamer. "Brain Endoscopy, a big neurosurgical revolution." AL-Kindy College Medical Journal 13, no. 2 (November 1, 2018): 1–5. http://dx.doi.org/10.47723/kcmj.v13i2.26.
Full textAbstract:
Endoscopy is a rapidly growing field of Neurosurgery, it is defined as the applying of endoscope to treat different conditions of brain pathology within cerebral ventricular system and beyond it, endoscopic procedures performed by using different equipment and recording system to make a better visualization enhancing the surgeon's view by increasing illumination and magnification to look around corner and to capture image on video or digital format for later studies.
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Bhardwaj, A., A. Anant, N. Bharadwaj, A. Gupta, and S. Gupta. "Stapedotomy using a 4 mm endoscope: any advantage over a microscope?" Journal of Laryngology & Otology 132, no. 9 (September 2018): 807–11. http://dx.doi.org/10.1017/s0022215118001548.
Full textAbstract:
AbstractObjectivesTo ascertain the feasibility of endoscopic (4 mm) stapedotomy, and compare intra- and post-operative variations with microscopic stapedotomies.MethodsForty otosclerosis patients were scheduled for microscopic or endoscopic stapedotomy. Intra-operative variables compared were: incision, canalplasty, canal wall curettage for ossicular assessment, chorda tympani manipulation, ability to perform stapes footplate perforation before its supra-structure removal, and operative time. Post-operative variables compared were ear pain and hearing improvement.ResultsOf the 20 microscopy patients, 4 required endaural incision and canalplasty because of canal overhangs, and 7 required canal wall curettage for ossicular assessment. None of the 20 endoscopy patients required these procedures. Chorda tympani was manipulated in 13 and 6 patients in the microscopy and endoscopy groups respectively, while the stapes footplate could be perforated in 5 and 11 patients respectively. Mean operative time was 50.25 and 76.05 minutes in the microscopy and endoscopy groups respectively. In the endoscopy group, mean air–bone gap was 37.12 and 10.73 dB pre- and post-operation respectively; in the microscopy group, these values were 35.95 and 13.81 dB.ConclusionEndoscopic stapedotomy has comparable hearing outcomes. Sinonasal endoscope serves as a better tool for: minimal incision, canalplasty avoidance, less chorda tympani mobilisation, and stapes footplate perforation ability.
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Resch, Klaus D. M., and H. W. S. Schroeder. "Endoneurosonography: Technique and Equipment, Anatomy and Imaging, and Clinical Application." Operative Neurosurgery 61, suppl_3 (September 1, 2007): ONS—146—ONS—160. http://dx.doi.org/10.1227/01.neu.0000289728.42954.d5.
Full textAbstract:
Abstract Objective: To evaluate the usefulness of transendoscopic ultrasound in neurosurgery, we studied two new sonoprobes measuring 6 and 8 French in diameter in 20 fresh specimens. The application and indication are discussed in the first clinical series of 75 patients. Methods: Sonocatheters (ALOKA, Meerbusch, Germany) 1.9 mm (6 French) and 2.4 mm (8 French) in diameter were introduced into the working channel of an endoscope. The preparations were done in nonfixed skulls in a surgical simulation-setting laboratory. Based on these experiences with imaging possibilities, intraoperative transendoscopic ultrasound was applied in 75 patients and a variety of lesions. It was used for imaging (41 patients), targeting (18 patients), and neuronavigation (16 patients) in neuroendoscopy. Results: The sonoprobe adds a transverse scan at the tip of the probe to the anterior endoscopic view. This axial scan to the longitudinal axis of the endoscope is geometrically comparable with radar scanning. Three probes working with 10, 15, and 20 MHz were used, resulting in a short penetration with a radius of 3 cm. The orthogonal scanning plane had limitations, which were documented. We observed precise imaging of well known anatomic structures and, moreover, achieved an additional dimension in endoscopy. The axial scan presents the anatomic landmarks like a map at the tip of the endoscope where the endoscope is represented as a spot. The real-time imaging and representation of the tip of the endoscope showed a capacity for navigation. This preclinical study rectified clinical application. The real-time imaging of this technique showed the ability of the navigation of endoscopes to detect more overall movements, such as blood flow or change of ventricle size during endoscopy. The primary benefit in this first clinical series was witnessed in difficult endoscopy cases and complex lesions, but benefit was also observed in cases in which vision through the endoscope alone was obscured. The main limitation was the result of little penetration depth and lack of anterior scanning. Conclusion: Application of transendoscopic ultrasound is appropriate in neurosurgery. Training is necessary to understand the imaging and the geometry of scans because this technique does not scan along the axis of the endoscope. Further development to overcome the current limits of this technique and more clinical experience are needed.
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Maehata, Tadateru, Yoshinori Sato, Yusuke Nakamoto, Masaki Kato, Akiyo Kawashima, Hirofumi Kiyokawa, Hiroshi Yasuda, Hiroyuki Yamamoto, and Keisuke Tateishi. "Updates in the Field of Submucosal Endoscopy." Life 13, no. 1 (December 30, 2022): 104. http://dx.doi.org/10.3390/life13010104.
Full textAbstract:
Submucosal endoscopy (third-space endoscopy) can be defined as an endoscopic procedure performed in the submucosal space. This procedure is novel and has been utilized for delivery to the submucosal space in a variety of gastrointestinal diseases, such as a tumor, achalasia, gastroparesis, and subepithelial tumors. The main submucosal endoscopy includes peroral endoscopic myotomy, gastric peroral endoscopic myotomy, Zenker peroral endoscopic myotomy, submucosal tunneling for endoscopic resection, and endoscopic submucosal tunnel dissection. Submucosal endoscopy has been used as a viable alternative to surgical techniques because it is minimally invasive in the treatment and diagnosis of gastrointestinal diseases and disorders. However, there is limited evidence to prove this. This article reviews the current applications and evidence regarding submucosal endoscopy while exploring the possible future clinical applications in this field. As our understanding of these procedures improves, the future of submucosal endoscopy could be promising in the fields of diagnostic and therapeutic endoscopy.