By Toyooki Sonoda
This e-book offers surgeons and gastroenterologists with state of the art innovations by way of complex colonoscopy. Chapters introduce equipment of removal polyps that weren't formerly amenable to colonoscopic snare polypectomy. complicated options equivalent to closure of perforations and intestinal stenting are greatly coated. The textual content continues a powerful emphasis on surgical/endoscopic method. vast dialogue on apparatus and ability acquisition is usually coated. As many readers won't ever have visible those advanced strategies ahead of, wide images and movies are supplied. The authors supply guidance, tips, and pitfalls that would support the reader contain those new ideas into their practice.
Advanced Colonoscopy: Polypectomy and past may be of significant worth to any physician or gastroenterologist at present acting colonoscopy and attracted to complicated techniques.
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Additional info for Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy
It is now well established that colonoscopic polypectomy can prevent the development of colorectal cancer and so reduce mortality due to this common disease [1, 2]. However, colonoscopic polypectomy can be tricky. Each polyp has a blood supply, and the larger the polyp, the larger its feeding and draining vessels. Large polypectomy wounds are prone to bleed . The colonic wall is relatively thin, especially in the cecum and ascending colon. Heat trauma to the colonic wall can cause a full-thickness perforation .
The training system for colorectal ESD consists of acquiring accurate diagnostic skills as well as developing the technical skill of therapeutic colonoscopy. A colorectal ESD training system must include instruction on how to use devices, how to use good positioning, and how to plan a strategy for success. Learning through DVDs, attending live demonstration courses, and hands-on training using animal organs are indispensable. After working as an assistant through several ESD procedures, an endoscopist can carefully start to conduct ESD as the main operator under a strict guidance from an ESD expert.
Piecemeal or En Bloc Jerry Waye has advised that the maximum “bite” that should be removed during one application of the snare is 2 cm . Larger bites can pull in deeper layers of the colon wall and can transect larger arteries with less efficient coagulation. This is good advice. However, it means that sessile polyps over 2 cm in diameter have to be removed piecemeal. This has been designated as the main disadvantage of conventional polypectomy and a reason why large polyps should be removed by endoscopic mucosal resection or endoscopic submucosal dissection.
Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy by Toyooki Sonoda