Статті в журналах: "Flexible endoscopy"

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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.

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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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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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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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Torres-Corzo, Jaime G., Leonardo Rangel-Castilla, Mario Alberto Islas-Aguilar, and Roberto Rodríguez-Della Vecchia. "A Novel Approach of Navigation-Assisted Flexible Neuroendoscopy." Operative Neurosurgery 14, no. 3 (May 18, 2017): E33—E37. http://dx.doi.org/10.1093/ons/opx118.

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Abstract BACKGROUND AND IMPORTANCE Neuronavigation-assisted endoscopy is commonly used for skull base and intraventricular surgery. Flexible neuroendoscopy offers certain advantages over rigid endoscopy; however, a major disadvantage of the flexible endoscope has been easy disorientation in the flexed position. Neuronavigation-assisted flexible neuroendoscopy was not available until now. This is the first report of the use of navigation-assisted flexible neuroendoscopy in a patient with hydrocephalus. CLINICAL PRESENTATION A 10-mo-old girl presented with irritability and vomiting to the emergency department and was found to have severe hydrocephalus. The patient underwent successful endoscopic third ventriculostomy and exploration of the ventricles (lateral, third, cerebral aqueduct, fourth) and basal cisterns with the flexible neuroendoscopy assisted with electromagnetic neuronavigation. CONCLUSION As demonstrated by this initial experience, neuronavigation-assisted flexible neuroendoscopy is a feasible and safe tool, endoscopic procedures with the flexible endoscope may be possible in a safer manner. We report the first use of neuronavigation-assisted flexible neuroendoscopy to perform an ETV and exploration of the entire ventricular system. Further evaluation will be necessary to define and expand its applications in neurosurgery.

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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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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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Hookey, Lawrence, David Armstrong, Rob Enns, Anne Matlow, Harminder Singh, and Jonathan Love. "Summary of Guidelines for Infection Prevention and Control for Flexible Gastrointestinal Endoscopy." Canadian Journal of Gastroenterology 27, no. 6 (2013): 347–50. http://dx.doi.org/10.1155/2013/639518.

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BACKGROUND: High-quality processes to ensure infection prevention and control in the delivery of safe endoscopy services are essential. In 2010, the Public Health Agency of Canada and the Canadian Association of Gastroenterology (CAG) developed a Canadian guideline for the reprocessing of flexible gastrointestinal endoscopy equipment.METHODS: The CAG Endoscopy Committee carefully reviewed the 2010 guidelines and prepared an executive summary.RESULTS: Key elements relevant to infection prevention and control for flexible gastrointestinal endoscopy were highlighted for each of the recommendations included in the 2010 document. The 2010 guidelines consist of seven sections, including administrative recommendations, as well as recommendations for endoscopy and endoscopy decontamination equipment, reprocessing endoscopes and accessories, endoscopy unit design, quality management, outbreak investigation and management, and classic and variant Creutzfeldt-Jakob Disease.DISCUSSION: The recommendations for infection prevention and control for flexible gastrointestinal endoscopy are intended for all individuals with responsibility for endoscopes in all settings where endoscopy is performed.

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Girard, Donna, and Pat Holland. "Flexible Endoscopy." Gastroenterology Nursing 28, no. 2 (March 2005): 167. http://dx.doi.org/10.1097/00001610-200503000-00045.

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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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Sutton, Erica, Sheree Carter Chase, Rosemary Klein, Yue Zhu, Carlos Godinez, Yassar Youssef, and Adrian Park. "Development of Simulator Guidelines for Resident Assessment in Flexible Endoscopy." American Surgeon 79, no. 1 (January 2013): 14–22. http://dx.doi.org/10.1177/000313481307900109.

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Virtual reality (VR) simulators may hold a role in the assessment of trainee abilities independent of their role as instructional instruments. Thus, we piloted a course in flexible endoscopy to surgical trainees who had met Accreditation Council for Graduate Medical Education endoscopy requirements to establish the relationship between metrics produced by a VR endoscopic simulator and trainee ability. After a didactic session, we provided faculty instruction to senior residents for Case 1 upper endoscopy and colonoscopy modules on the CAE Endoscopy VR. Course conclusion was defined as a trainee meeting all proficiency standards in basic endoscopic procedures on the simulator. Simulator metrics and course evaluation comprised data. Eleven and eight residents participated in the colonoscopy and upper endoscopy courses, respectively. Average time to reach proficiency standards for esophagogastroduodenoscopy was 6 and 13 minutes for colonoscopy after a median of one (range, one to two) and one (range, one to four) task repetitions, respectively. Faculty instruction averaged 7.5 minutes of instruction per repetition. A subjective course evaluation demonstrated that the course improved learners’ knowledge of the subject and comfort with endoscopic equipment. Within a VR-based curriculum, experienced residents rapidly achieved task proficiency. The resultant scores may be used as simulator guidelines for resident assessment and readiness to perform flexible endoscopy.

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Dunkin, B. J. "Flexible Endoscopy Simulators." Surgical Innovation 10, no. 1 (March 1, 2003): 29–35. http://dx.doi.org/10.1177/107155170301000106.

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Cowen, Alistair E. "The Clinical Risks of Infection Associated with Endoscopy." Canadian Journal of Gastroenterology 15, no. 5 (2001): 321–31. http://dx.doi.org/10.1155/2001/691584.

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The cleaning of flexible endoscopes is difficult and time consuming. Any method of attempted sterilization or high level disinfection will fail if prior cleaning has been defective. Inadequate reprocessing of endoscopes may result in patient to patient transmission of serious bacterial and viral diseases or infection with endemic hospital pathogens. Antibiotic prophylaxis is required to prevent septicemia and bacterial endocarditis in high risk patients undergoing specific endoscopic procedures. Prevention of serious endoscopy-associated clinical infections requires strict compliance with detailed reprocessing protocols by specially trained nursing staff.

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Ogiwara, Hideki, and Nobuhito Morota. "Flexible endoscopy for management of intraventricular brain tumors in patients with small ventricles." Journal of Neurosurgery: Pediatrics 14, no. 5 (November 2014): 490–94. http://dx.doi.org/10.3171/2014.7.peds13648.

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Object Endoscopic surgery is generally withheld in patients with small ventricles due to difficulties in ventricular cannulation and intraventricular manipulation. The effectiveness of flexible endoscopy for management of intraventricular brain tumors in patients with small ventricles was evaluated. Methods Forty-five patients who underwent endoscopic surgery with a flexible endoscope for intraventricular brain tumors were divided into small-ventricle and ventriculomegaly groups according to the frontal and occipital horn ratio (FOR). Retrospective review of these cases was performed and achievement of surgical goals and morbidity were assessed. Results Among the 45 patients, there were 14 with small ventricles and 31 with ventriculomegaly. In the smallventricle group, targeted tumors were located in the suprasellar region in 12 patients and in the pineal region in 2. In the ventriculomegaly group, tumors were located in the pineal region in 15 patients, in the suprasellar region in 9, in the lateral ventricle in 4, in the midbrain in 2, and in the fourth ventricle in 1. In the small-ventricle group, ventricular cannulation was successful and the surgical goals were accomplished in all patients. In ventriculomegaly group, sampling of the tumor was not diagnostic due to intraoperative hemorrhage in 1 patient. There were no significant differences in the rate of achieving the surgical goals or the morbidity between the 2 groups. Conclusions Endoscopic surgery using a flexible endoscope is useful for management of intraventricular brain tumors in patients with small ventricles. A flexible endoscope allows excellent maneuverability in introducing the device into the lateral ventricle and manipulating through small ventricles.

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Sprau, Annelise Claire, and Heather J. McCrea. "Intracranial arachnoid cysts in an infant: A technical note on the innovative use of navigation and flexible endoscopy for cyst fenestration." Surgical Neurology International 12 (April 14, 2021): 160. http://dx.doi.org/10.25259/sni_81_2021.

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Background: Intracranial arachnoid cysts (ACs) are a cerebral spinal fluid (CSF) collection within the meninges. They typically arise during embryologic development. Some are stable overtime with little consequence, but large or growing cysts may require surgical intervention. The optimal surgical technique is debated and may be more technically challenging in the infant age group. Case Description: Our unique case report details a 10-month-old (6 months corrected age) infant who presented with a drastic increase in head circumference and was found to have midline shift and three cysts – one large and two smaller ones. He was treated with an innovative surgical approach combining stereotactic introduction of a catheter to facilitate subsequent flexible endoscopy allowing three separate cysts to be treated through one small surgical incision with no complications and a stable examination on 2-year follow-up. Conclusion: Symptomatic ACs in the infant population that require treatment can be addressed with open surgery to fenestrate the cyst, endoscopic cyst fenestration, or cystoperitoneal shunting. Typically, surgeons must choose between a rigid endoscope which allows stereotactic navigation or a flexible endoscope which allows multiple trajectories but precludes navigation. Our case demonstrates that combining stereotactic ventricular placement before flexible endoscopy provides the benefit of both approaches and allows for successful endoscopic treatment in a young patient with durable results.

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Muntz, Harlan. "Navigation of the Nose with Flexible Fiberoptic Endoscopy." Cleft Palate-Craniofacial Journal 29, no. 6 (November 1992): 507–10. http://dx.doi.org/10.1597/1545-1569_1992_029_0507_notnwf_2.3.co_2.

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The introduction of flexible fiberoptics into medicine revolutionized the evaluation and treatment of velopharyngeal dysfunction. In this paper, rigid endoscopy and flexible fiberoptic scopes are discussed, including their respective advantages and disadvantages. Anesthetic and anatomic considerations relative to the endoscopic procedure are presented. Transnasal endoscopy permits documentation of static and dynamic anatomy, information that may be fundamental for the understanding and treatment of patients with velopharyngeal dysfunction.

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Farzaneh, Cyrus A., Mehraneh D. Jafari, William Q. Duong, Areg Grigorian, Joseph C. Carmichael, Steven D. Mills, Matthew T. Brady, and Alessio Pigazzi. "Evaluation of Pelvic Anastomosis by Endoscopic and Contrast Studies Prior to Ileostomy Closure: Are Both Necessary? A Single Institution Review." American Surgeon 86, no. 10 (October 2020): 1296–301. http://dx.doi.org/10.1177/0003134820964227.

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Contrast enema is the gold standard technique for evaluating a pelvic anastomosis (PA) prior to ileostomy closure. With the increasing use of flexible endoscopic modalities, the need for contrast studies may be unnecessary. The objective of this study is to compare flexible endoscopy and contrast studies for anastomotic inspection prior to defunctioning stoma reversal. Patients with a protected PA undergoing ileostomy closure between July 2014 and June 2019 at our institution were retrospectively identified. Demographics and clinical outcomes in patients undergoing preoperative evaluation with endoscopic and/or contrast studies were analyzed. We identified 207 patients undergoing ileostomy closure. According to surgeon’s preference, 91 patients underwent only flexible endoscopy (FE) and 100 patients underwent both endoscopic and contrast evaluation (FE + CE) prior to reversal. There was no significant difference in pelvic anastomotic leak (2.2% vs. 1%), anastomotic stricture (1.1% vs. 6%), pelvic abscess (2.2% vs. 3.0%), or postoperative anastomotic complications (4.4% vs. 9%) between groups FE and FE + CE ( P > .05). Flexible endoscopy alone appears to be an acceptable technique for anastomotic evaluation prior to ileostomy closure. Further studies are needed to determine the effectiveness of different diagnostic modalities for pelvic anastomotic inspection.

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Mastorakos, Panagiotis, I. Jonathan Pomeraniec, Jean-Paul Bryant, Prashant Chittiboina, and John D. Heiss. "Flexible thecoscopy for extensive spinal arachnoiditis." Journal of Neurosurgery: Spine 36, no. 2 (February 1, 2022): 325–35. http://dx.doi.org/10.3171/2021.4.spine21483.

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OBJECTIVE Chronic adhesive spinal arachnoiditis (SA) is a complex disease process that results in spinal cord tethering, CSF flow blockage, intradural adhesions, spinal cord edema, and sometimes syringomyelia. When it is focal or restricted to fewer than 3 spinal segments, the disease responds well to open surgical approaches. More extensive arachnoiditis extending beyond 4 spinal segments has a much worse prognosis because of less adequate removal of adhesions and a higher propensity for postoperative scarring and retethering. Flexible neuroendoscopy can extend the longitudinal range of the surgical field with a minimalist approach. The authors present a cohort of patients with severe cervical and thoracic arachnoiditis and myelopathy who underwent flexible endoscopy to address arachnoiditis at spinal segments not exposed by open surgical intervention. These observations will inform subsequent efforts to improve the treatment of extensive arachnoiditis. METHODS Over a period of 3 years (2017–2020), 10 patients with progressive myelopathy were evaluated and treated for extensive SA. Seven patients had syringomyelia, 1 had spinal cord edema, and 2 had spinal cord distortion. Surgical intervention included 2- to 5-level thoracic laminectomy, microscopic lysis of adhesions, and then lysis of adhesions at adjacent spinal levels performed using a rigid or flexible endoscope. The mean follow-up was 5 months (range 2–15 months). Neurological function was examined using standard measures. MRI was used to assess syrinx resolution. RESULTS The mean length of syringes was 19.2 ± 10 cm, with a mean maximum diameter of 7.0 ± 2.9 mm. Patients underwent laminectomies averaging 3.7 ± 0.9 (range 2–5) levels in length followed by endoscopy, which expanded exposure by an average of another 2.4 extra segments (6.1 ± 4.0 levels total). Endoscopic dissection of extensive arachnoiditis in the dorsal subarachnoid space proceeded through a complex network of opaque arachnoidal bands and membranes bridging from the dorsal dura mater to the spinal cord. In less severely problematic areas, the arachnoid membrane was transparent and attached to the spinal cord through multifocal arachnoid adhesions bridging the subarachnoid space. The endoscope did not compress or injure the spinal cord. CONCLUSIONS Intrathecal endoscopy allowed visual assessment and safe removal of intradural adhesions beyond the laminectomy margins. Further development of this technique should improve its effectiveness in opening the subarachnoid space and untethering the spinal cord in cases of extensive chronic adhesive SA.

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Chaudhari, Sandip Kumar S., and Sonalben M. Chaudhary. "Endoscopic management of foreign bodies in the upper gastrointestinal tract." International Surgery Journal 7, no. 7 (June 25, 2020): 2226. http://dx.doi.org/10.18203/2349-2902.isj20202826.

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Background: Foreign body ingestion and food bolus impaction is a common clinical scenario and can present as an endoscopic emergency. Though majority of them pass spontaneously 10-20% require endoscopic intervention. Flexible endoscopy is recommended as therapeutic measure with minimal complications. The aim of our study is to present 5 years’ experience in dealing with foreign bodies in the upper gastrointestinal tract.Methods: Cases of foreign body ingestion admitted to department of general surgery from March 2015 to March 2020 were evaluated. The patients were reviewed with details on age, sex, type of FB, its location in gastrointestinal tract, treatment and outcome.Results: A total of 55 cases were studied. Age range was 1-85 years. Males were predominant 61.81%. Coins were found most commonly 63.6%. Esophagus was the commonest site of FB lodgement 70.9%. Upper esophagus being the most common 36.36%. Upper gastrointestinal flexible endoscopy was useful in retrieving FB in all the 55 cases. There were no complications throughout the study period.Conclusions: Flexible endoscopy should be used as definitive treatment and endoscopic treatment is safe and effective.

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Mirji, Pramod, Vikas Daddenavar, and Eshwar Kalburgi. "Endoscopic management of foreign bodies in the upper gastrointestinal tract." International Surgery Journal 4, no. 10 (September 27, 2017): 3277. http://dx.doi.org/10.18203/2349-2902.isj20174105.

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Background: Foreign body ingestion and food bolus impaction is a common clinical scenario and can present as an endoscopic emergency. Though majority of them pass spontaneously 10-20% require endoscopic intervention. Flexible endoscopy is recommended as therapeutic measure with minimal complications. The aim of our study is to present 2 years’ experience in dealing with foreign bodies in the upper gastrointestinal tract.Methods: Cases of foreign body (FB) ingestion admitted to department of general surgery from January 2015 to December 2016 were evaluated. The patients were reviewed with details on age, sex, type of FB, its location in gastrointestinal tract, treatment and outcome.Results: A total of 23 cases were studied. Age range was 2-75 years. Males were predominant (60.87%). Coins were found most commonly (52.17%). Esophagus was the commonest site of FB lodgment (65.22%). Upper esophagus being the most common (39.13%). Upper gastrointestinal flexible endoscopy was useful in retrieving FB in all the 23 cases. There were no complications throughout the study period.Conclusions: Flexible endoscopy should be used as definitive treatment and endoscopic treatment is safe and effective.

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Torres-Corzo, Jaime, Roberto Rodriguez-Della Vecchia, and Leonardo Rangel-Castilla. "Bruns syndrome caused by intraventricular neurocysticercosis treated using flexible endoscopy." Journal of Neurosurgery 104, no. 5 (May 2006): 746–48. http://dx.doi.org/10.3171/jns.2006.104.5.746.

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Object Neurocysticercosis is the most frequent cause of hydrocephalus in adults in regions where the disease is endemic, including Latin America. The prognosis for intraventricular neurocysticercosis is worse than that for the intraparenchymal form of the disease, making treatment especially important. Although active and viable intraventricular cysts produce no reaction in the host, they can cause noncommunicating hydrocephalus, whose onset is frequently abrupt. Sometimes the increasing intracranial pressure due to obstruction of the cerebral aqueduct (ball-valve mechanism) is intermittent, producing relapsing/remitting symptoms; this life-threatening phenomenon is called “Bruns syndrome.” Methods Between 1996 and 2004, among a group of 285 patients with neurocysticercosis and Bruns syndrome caused by cysticercal cysts of the third ventricle was diagnosed in seven patients by using magnetic resonance imaging. An endoscopic procedure with a flexible cerebral endoscope was performed, intact parasitic cysts were removed, and a complete exploration was undertaken to look for more cysticercal cysts in the whole ventricular system and the subarachnoid basal cisterns. There were no deaths or complications. All seven patients were asymptomatic during a follow-up period ranging from 1 to 5 years. Conclusions Flexible cerebral endoscopy allows one, in a minimally invasive manner, to approach the ventricular system and subarachnoid basal cisterns and to remove intraventricular neurocysticercal cysts. Flexible endoscopy is an alternative treatment for Bruns syndrome caused by neurocysticercosis of the third ventricle.

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Winder, Joshua S., and Ryan M. Juza. "Flexible endoscopy: surgical education." Annals of Laparoscopic and Endoscopic Surgery 4 (April 2019): 43. http://dx.doi.org/10.21037/ales.2019.04.07.

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Troy, A. J., T. Anagnostou, and D. A. Tolley. "Flexible upper tract endoscopy." BJU International 93, no. 5 (March 2004): 671–79. http://dx.doi.org/10.1111/j.1464-410x.2003.04693.x.

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Schellhase, Dennis E. "Pediatric flexible airway endoscopy." Current Opinion in Pediatrics 14, no. 3 (June 2002): 327–33. http://dx.doi.org/10.1097/00008480-200206000-00009.

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Radhakrishnan, Anant. "Advances in Flexible Endoscopy." Veterinary Clinics of North America: Small Animal Practice 46, no. 1 (January 2016): 85–112. http://dx.doi.org/10.1016/j.cvsm.2015.08.003.

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Dhaliwal, Harpal S., Saroj K. Sinha, and Rakesh Kochhar. "Endoscopic management of Zenker’s diverticulum." Journal of Digestive Endoscopy 06, no. 02 (April 2015): 045–54. http://dx.doi.org/10.4103/0976-5042.159235.

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AbstractZenker’s diverticulum (ZD) is a posterior hypopharyngeal mucosal and submucosal outpouching through an area of relative muscular weakness, known as Killian’s triangle. It is an uncommon but highly treatable cause of mechanical dysphagia in elderly patients. Diagnosis is established by esophagography and upper endoscopy. The treatment has evolved with the advancement in the understanding of underlying pathophysiology. Traditionally, the management had been open surgical exposure and cricopharyngeal myotomy, combined with diverticular excision, suspension or inversion. Peroral endoscopic techniques (rigid and flexible) have gained popularity as minimally invasive and effective therapeutic options, with lesser mortality and morbidity. Flexible endoscopic myotomy offers additional benefits over rigid endoscopic techniques, as it does not require general anesthesia and neck hyperextension. The initial results of flexible endoscopy are quite encouraging, but long-term data are not yet available. For the optimal outcome, flexible endotherapy requires a formidable endoscopic skill, sound knowledge of the neck anatomy and meticulous understanding of the electrosurgical principles. In this article, we have comprehensively reviewed the current understanding of the pathophysiology involved and various techniques used in the management of ZD, with a focus on flexible endoscopic techniques.

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Goulding, Catherine. "An introduction to endoscopy Part 1: Flexible endoscopes." Veterinary Nursing Journal 23, no. 3 (March 2008): 14–18. http://dx.doi.org/10.1080/17415349.2008.11013661.

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Willingham, Field F., and William R. Brugge. "Taking NOTES: translumenal flexible endoscopy and endoscopic surgery." Current Opinion in Gastroenterology 23, no. 5 (September 2007): 550–55. http://dx.doi.org/10.1097/mog.0b013e32828621b3.

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Lorenz, Reinhard, Gabriele Jorysz, and Meinihard Clasen. "The globus syndrome: value of flexible endoscopy of the upper gastrointestinal tract." Journal of Laryngology & Otology 107, no. 6 (June 1993): 535–37. http://dx.doi.org/10.1017/s0022215100123631.

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Flexible endoscopy of the upper gastrointestinal tract usually does not form part of the primary diagnostic evaluation of the globus syndrome. In a prospective trial, a flexible endoscopy was performed in 51 globus patients with normal results of the laryngologic and radiographic examination. Pathologic findings requiring therapy were diagnosed in 70.6 per cent of cases. The most frequent findings were reflux oesophagitis (n = 24; 47 per cent) and hiatial hernia (n = 25; 49 per cent). In 16 cases (31,4 per cent) these were accompanied by other pathologic lesions. A total of 32 patients (62.7 per cent) suffered from oesophageal diseases as sole aetiologic factors of the globus syndrome, which led us to postulate a causative relationship in these cases. Flexible endoscopy therefore can contribute significantly to the differential diagnosis of the globus syndrome. It must be kept in mind, however, that there is a ‘blind zone’ for endoscopic assessment in a region of the hypopharynx, thus some indications may require rigid endoscopy.

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Robertson, Elise. "Endoscopy: part 2 - flexible endoscopy: the inside story." Companion Animal 18, no. 4 (June 2013): 151–57. http://dx.doi.org/10.12968/coan.2013.18.4.151.

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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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MacSween, H. Miller. "Canadian Association of Gastroenterology Practice Guideline for Granting of Privileges to Perform Gastrointestinal Endoscopy." Canadian Journal of Gastroenterology 11, no. 5 (1997): 429–32. http://dx.doi.org/10.1155/1997/761054.

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The purpose of this statement is to provide guidelines to assist hospital credentialling committees in their task of granting privileges to perform gastrointestinal endoscopy. Endoscopy of the gastrointestinal tract has evolved over the past 30 years as a potent tool to assist in the evaluation, diagnosis and therapy of patients with gastrointestinal tract disorders. Although gastrointestinal endoscopy was initially developed as a purely diagnostic tool, the development of therapeutic endoscopic techniques has dramatically expanded the role of gastrointestinal endoscopy, frequently to a therapeutic one. In setting guidelines for training and credentialling one must recognize that, excluding flexible sigmoidoscopy, endoscopists should be well trained in therapeutic endoscopy.

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Ullah, Saif, Faisal S. Ali, and Bing-Rong Liu. "Advancing flexible endoscopy to natural orifice transluminal endoscopic surgery." Current Opinion in Gastroenterology 37, no. 5 (June 4, 2021): 470–77. http://dx.doi.org/10.1097/mog.0000000000000753.

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Nakayama, Don K. "How Technology Shaped Modern Surgery." American Surgeon 84, no. 6 (June 2018): 753–60. http://dx.doi.org/10.1177/000313481808400613.

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The history of endoscopy and minimally invasive surgery is the story of technological advances in illumination, optics, and imaging that allowed operations to be performed within the body. After invention of the incandescent bulb by Joseph Swan and Thomas Edison in 1879, the basic design of early cystoscopes remained unchanged during the first half of the 20th century. Three inventions made endoscopy and laparoscopy possible. Invented in the 1950s, the Hopkins glass rod lens system was so elegant and effective—it gave images 80 times better than traditional Galilean optics—that endoscopes of the same design remain in use today. Also, originating in the same decade, fiber optics had in turn two major contributions: Flexible endoscopy and the transfer of light from a high voltage source into the body to illuminate internal structures and organs. Solid-state camera technology, developed in the late 1970s and 1980s, gave images of exceptional detail from a camera chip at the eyepiece of an endoscope. The panorama of advances created by the same technologies—global telecommunications, cellphone cameras, images from interplanetary space probes—reveals endoscopy and laparoscopic surgery as two more examples of today's technological age.

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Hayden, Lystra, Debra Boyer, Erik Bradford Hysinger, Paul E. Moore, Albert Faro, Kevin C. Wilson, and Carey C. Thomson. "Flexible Airway Endoscopy in Children." Annals of the American Thoracic Society 12, no. 12 (December 2015): 1873–75. http://dx.doi.org/10.1513/annalsats.201509-612cme.

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Midulla, F., J. de Blic, A. Barbato, A. Bush, E. Eber, S. Kotecha, E. Haxby, C. Moretti, P. Pohunek, and F. Ratjen. "Flexible endoscopy of paediatric airways." European Respiratory Journal 22, no. 4 (October 2003): 698–708. http://dx.doi.org/10.1183/09031936.02.00113202.

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Cathey, L., and F. L. Greene. "Flexible Endoscopy and Enteral Nutrition." Surgical Innovation 10, no. 1 (March 1, 2003): 37–42. http://dx.doi.org/10.1177/107155170301000107.

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Chand, B., J. Felsher, and J. Ponsky. "Future Trends in Flexible Endoscopy." Surgical Innovation 10, no. 1 (March 1, 2003): 49–54. http://dx.doi.org/10.1177/107155170301000109.

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Schwab, Katie, and Sukhpal Singh. "An introduction to flexible endoscopy." Surgery (Oxford) 29, no. 2 (February 2011): 80–84. http://dx.doi.org/10.1016/j.mpsur.2010.11.014.

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Swain, C. Paul, Sritharan S. Kadirkamanathan, Feng Gong, Kam Chai Lai, Rita S. Ratani, Geoffrey J. Brown, and Timothy N. Mills. "Knot tying at flexible endoscopy." Gastrointestinal Endoscopy 40, no. 6 (November 1994): 722–29. http://dx.doi.org/10.1016/s0016-5107(94)70116-4.

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Gong, Feng, Paul Swain, Sritharan Kadirkamanathan, Clive Hepworth, Jan Laufer, Julia Shelton, and Tim Mills. "Cutting thread at flexible endoscopy." Gastrointestinal Endoscopy 44, no. 6 (December 1996): 667–74. http://dx.doi.org/10.1016/s0016-5107(96)70049-4.

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Sum, Steffen, and Cynthia R. Ward. "Flexible Endoscopy in Small Animals." Veterinary Clinics of North America: Small Animal Practice 39, no. 5 (September 2009): 881–902. http://dx.doi.org/10.1016/j.cvsm.2009.05.009.

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Hedenbro, J. L., M. Ekelund, and R. Willen. "Bioptic techniques in flexible endoscopy." Surgical Endoscopy 6, no. 3 (May 1992): 130–33. http://dx.doi.org/10.1007/bf02309085.

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Chernov, Aleksandr, Andrey Lukomskiy, Ol'ga Kazakova, and Elizaveta Elanceva. "How to use endoscopy equipment and not break it?" Russian veterinary journal 2021, no. 1 (March 22, 2021): 19–24. http://dx.doi.org/10.32416/2500-4379-2021-1-19-24.

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The article recommends brief principles for working with endoscopic equipment. Maintenance of devices, endoscopes and instruments. Algorithms for cleaning and disinfection of flexible, rigid endoscopes and more are given.

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Swain, Paul, Vahid Sadaat, Rodney Brenneman, and Richard Ewers. "Force Transmission at Flexible Endoscopy with Conventional Endoscopes and Shape Locking Endoscope Guide Catheter." Gastrointestinal Endoscopy 59, no. 5 (April 2004): P148. http://dx.doi.org/10.1016/s0016-5107(04)00711-4.

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45

Pulvirenti, Elia, Adriana Toro, and Isidoro Di Carlo. "Update on Instrumentations for Cholecystectomies Performed via Transvaginal Route: State of the Art and Future Prospectives." Diagnostic and Therapeutic Endoscopy 2010 (February 11, 2010): 1–4. http://dx.doi.org/10.1155/2010/405469.

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Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an innovative approach in which a flexible endoscope enters the abdominal cavity via the transesophageal, transgastric, transcolonic, transvaginal or transvescical route, combining the technique of minimally invasive surgery with flexible endoscopy. Several groups have described different modifications by using flexible endoscopes with different levels of laparoscopic assistance. Transvaginal cholecystectomy (TVC) consists in accessing the abdominal cavity through a posterior colpotomy and using the vaginal incision as a visual or operative port. An increasing interest has arisen around the TVC; nevertheless, the most common and highlighted concern is about the lack of specific instruments dedicated to the vaginal access route. TVC should be distinguished between “pure”, in which the entire operation is performed through the transvaginal route, and “hybrid”, in which the colpotomy represents only a support to introduce instruments and the operation is performed mainly by the classic transabdominal-introduced instruments. Although this new technique seems very appealing for patients, on the other hand it is very challenging for the surgeon because of the difficulties related to the mode of access, the limited technology currently available and the risk of complications related to the organ utilized for access. In this brief review all the most recent advancements in the field of TVC's techniques and instrumentations are listed and discussed.

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Nelson, Douglas B., and Paul C. Adams. "Infection Control During Gastrointestinal Endoscopy." Canadian Journal of Gastroenterology 21, no. 1 (2007): 13–15. http://dx.doi.org/10.1155/2007/169846.

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Dr Douglas Nelson is a staff physician in the department of gastroenterology at the Minneapolis VA Medical Center (Minnesota, USA) and a Professor of Medicine at the University of Minnesota (USA). He has written numerous articles on the subject of infection control during gastrointestinal endoscopy, and was the lead author of the "Multi-society guideline for reprocessing flexible gastrointestinal endoscopes" (1).

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Kume, Keiichiro, Nobuo Sakai, and Toru Ueda. "Development of a Novel Gastrointestinal Endoscopic Robot Enabling Complete Remote Control of All Operations: Endoscopic Therapeutic Robot System (ETRS)." Gastroenterology Research and Practice 2019 (November 4, 2019): 1–5. http://dx.doi.org/10.1155/2019/6909547.

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Background and Objective. The master and slave transluminal endoscopic robot and other flexible endoscopy platforms are designed primarily for the remote control of forceps, with manipulation of the endoscope itself still dependent on conventional techniques. We have developed an endoscopic therapeutic robot system (ETRS) that provides complete remote control of all forceps and endoscope operations. Method. We carried out endoscopic submucosal dissection (ESD) in porcine stomachs using the ETRS. All procedures were completed with the endoscopist seated at the console the entire time. Results. Total en bloc resection was achieved in all 7 cases with no complications. The mean total procedure time was 36.14±14.98 min, the mean size of the resected specimen was 3.39±0.66 cm×3.03±0.63 cm, and the mean dissection time was 14.91±8.61 min. Conclusion. We successfully used the ETRS to perform completely remote-controlled ESD in porcine stomachs.

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Jones, RP, NA Stylianides, AG Robertson, VSK Yip, and G. Chadwick. "National survey on endoscopy training in the UK." Annals of The Royal College of Surgeons of England 97, no. 5 (July 2015): 386–89. http://dx.doi.org/10.1308/003588415x14181254790400.

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Introduction Gastrointestinal (GI) endoscopy is an important skill for both gastroenterologists and general surgeons but concerns have been raised about the provision and delivery of training. This survey aimed to evaluate and compare the delivery of endoscopy training to gastroenterology and surgical trainees in the UK. Methods A nationwide electronic survey was carried out of UK gastroenterology and general surgery trainees. Results There were 216 responses (33% gastroenterologists, 67% surgeons). Gastroenterology trainees attended more non-training endoscopy lists (mean: 3.0 vs 1.2) and training lists than surgical trainees (mean: 0.9 vs 0.5). A significantly higher proportion of gastroenterologists had already achieved accreditation in gastroscopy (60.8% vs 28.9%), colonoscopy (66.7% vs 1.4%) and flexible sigmoidoscopy (33.3% vs 3.0%). More gastroenterology trainees aspired to achieve accreditation in gastroscopy (97.2% vs 79.2%), flexible sigmoidoscopy (91.7% vs 70.1%) and colonoscopy (88.8% vs 55.5%) by completion of training. By completion of training, surgeons were less likely than gastroenterologists to have completed the required number of procedures to gain accreditation in gastroscopy (60.3% vs 91.3%), flexible sigmoidoscopy (64.6% vs 68.6%) and colonoscopy (60.3% vs 70.3%). Conclusions This survey highlights marked disparities between surgical and gastroenterology trainees in both aiming for and achieving accreditation in endoscopy. Without changes to the delivery and provision of training as well as clarification of the role of endoscopy training in a surgical training programme, future surgeons will not be able to perform essential endoscopic assessment of patients as part of their management algorithm.

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Primo, Mariusa G., Dayane M. Costa, Simone V. Guadagnin, Adriana S. Azevedo, Michelle J. Alfa, Karen Vickery, Lara Stefânia N. Leão-Vasconcelos, and Anaclara F. Tipple. "815. Biofilm Accumulation in New Flexible Gastroscope Channels within 30 Days in Clinical Use." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S449—S450. http://dx.doi.org/10.1093/ofid/ofaa439.1004.

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Abstract Background Flexible endoscopes are complex-design reusable devices, with long and narrow channels, making reprocessing difficult. Biofilm formation is a key factor for persistent contamination, as it protects microorganism against cleaning and disinfection agents. The aim of this study was to assess the accumulation of biofilm on the inner surfaces of new flexible gastroscope channels after 30 days of patient-use and full reprocessing. Methods Three flexible gastroscopes (FG) (GIF–Q150, OlympusTM) with new internal channels (TeflonTM) were subjected to 30 days of clinical use and reprocessing by trained nursing personnel, using a revised reprocessing protocol, at the endoscopy service of a Brazilian teaching hospital (235 beds). The reprocessing protocol included: pre-cleaning; manual cleaning; automated cleaning and disinfection - 2% Glutaraldehyde; manual drying (forced-air drying) and alcohol rinsing, and storage in vertical position in exclusive cabinets. Then, internal channels were removed from the three patient-ready FG (three biopsy, three air, three water and three air/water junction channels), and the inner surface subjected to bacteriological culture (~30 cm) (n=9) and Scanning Electron Microscopy (SEM) (~1 cm) (n=12). Air/water junctions (~1 cm) were subjected to SEM only. Results The average of use/reprocessing of the FG was 60 times. Bacterial growth was detected in 6/9 channels (three from FG#1 showed residual moisture) and seven bacterial isolates were recovered, most from air or water channels (Fig 1). Inner surface structural damage was identified in 11/12 channels by SEM. Extensive biofilm was detected in air, water and air/water junction channels (7/12) (Fig 2). Residuals matter were detected in all channels (12/12). Fig 1. Distribution of bacterial growth and genera/species identified in new flexible gastroscope channels after 30 days of patient-use and reprocessing at the endoscopy service of a large Brazilian teaching hospital. *FG1: flexible gastroscope nº1 **FG2: flexible gastroscope nº2 ***FG3: flexible gastroscope nº3 ¥Moisture was visually detected inside the channels during longitudinal cutting for SEM. Fig 2. Scanning Electron Micrographs showing extensive biofilm, containing bacilli/rods and/or cocci shape bacteria, on the inner surface of new flexible gastroscope channels after 30 days of patient-use and reprocessing at the endoscopy service of a large Brazilian teaching hospital. *FG1: flexible gastroscope nº1 **FG2: flexible gastroscope nº2 ***FG3: flexible gastroscope nº3 Conclusion The short timeframe before damage and biofilm accumulation in the channels were evident and suggests that improving endoscope design is necessary, while better reprocessing methods and channel maintenance needs to be investigated in detail. Improving design, maintenance and reprocessing of endoscopes will ensure safe use of these devices. Disclosures Michelle J. Alfa, B.Sc., M.Sc., Ph.D, Healthmark (Consultant, Other Financial or Material Support, Royalty monies from University of Manitoba that are provided through a License agreement with Healthmark)Kikkoman (Consultant)Olympus (Consultant, Advisor or Review Panel member, Speaker’s Bureau)STERIS (Consultant, Speaker’s Bureau)

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Dawood, Mohammed R., and Ammar H. Khammas. "Diagnostic Accuracy of Radiology and Endoscopy in the Assessment of Adenoid Hypertrophy." An International Journal of Otorhinolaryngology Clinics 9, no. 1 (February 2, 2017): 6–9. http://dx.doi.org/10.5005/jp-journals-10003-1251.

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ABSTRACT Aim To clarify the diagnostic accuracy of the lateral X-ray of nasopharynx, and the flexible nasopharyngoscopy in the assessment of adenoid hypertrophy, with the preoperative rigid nasal endoscopic observation, as it was considered as a reference standard guide. Materials and methods This is a prospective observational study that included 80 children who planned to undergo adenoidectomy due to the symptoms found related to adenoid hypertrophy. All the children underwent a relevant clinical history and full ear, nose, and throat (ENT) examination, and the grading of adenoid hypertrophy was done preoperatively with the lateral X-ray of the nasopharynx and the flexible nasopharyngoscopy. These findings were analyzed and compared with the peroperative rigid nasal endoscopic assessment of adenoid hypertrophy, which was considered as a reference guide. Results There were 44 boys (55%) and 36 girls (45%), with mean age of 5.176 (±1.873) years, and the highest frequency of adenoid hypertrophy was found in the age group of 4 to 6 years (62.45%); the most common grade of the adenoid size in all the types of the assessment was grade 3. The assessment of adenoid grading by both flexible and peroperative rigid nasal endoscopy versus radiology was statistically significant, with p value of 0.0001, while the adenoid grading between flexible and peroperative rigid nasal endoscopic assessment was almost comparable, as no significant difference was found, with p value of 0.46. Conclusion Flexible nasopharyngoscopy was a more reliable diagnostic tool in the assessment of the adenoid size than lateral nasopharyngeal X-ray, as it correlates well with peroperative rigid nasal endoscopic finding. How to cite this article Dawood MR, Khammas AH. Diagnostic Accuracy of Radiology and Endoscopy in the Assessment of Adenoid Hypertrophy. Int J Otorhinolaryngol Clin 2017;9(1):6-9.

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