By Toyooki Sonoda
This publication presents surgeons and gastroenterologists with cutting-edge strategies when it comes to complex colonoscopy. Chapters introduce equipment of elimination polyps that weren't formerly amenable to colonoscopic snare polypectomy. complex strategies akin to closure of perforations and intestinal stenting are widely coated. The textual content keeps a robust emphasis on surgical/endoscopic process. wide dialogue on gear and talent acquisition is additionally lined. As many readers won't ever have noticeable those advanced systems ahead of, broad photos and videos are supplied. The authors offer counsel, tips, and pitfalls that may aid the reader comprise those new innovations into their practice.
Advanced Colonoscopy: Polypectomy and past could be of serious price to any doctor or gastroenterologist at present acting colonoscopy and attracted to complicated techniques.
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Additional resources for Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy
The polyp is positioned at 6 o’clock, and the snare opened over the part of the polyp that comes most easily to view. The snare sheath is placed just proximal to the polyp and pushed down toward the bowel wall. This levers the polyp up into the loop of the snare. Suction will further pull the polyp up into the snare loop, and a few wiggles can consolidate this even further. The snare is then tightened gradually until it is tight around the polyp. M. Church Fig. 3 (a) Medium-sized sessile polyp in the ascending colon.
The HookKnife has a right angle bend at the tip of the needle knife. The direction of the hook can be controlled via handle rotation, which helps in the important task of keeping the hook oriented in a parallel orientation with the bowel wall to prevent perforation. The FlexKnife has a soft, thick, and looped knife tip, which acts well to prevent perforation. Furthermore, the tip of the outer sheath is rolled over by 1 mm, which functions as a stopper to keep the depth of tissue incision constant.
However, their position should be marked too. Conclusion Most colorectal polyps can be removed endoscopically, and most can be removed by conventional techniques using snare excision. Colonoscopists who are hesitant or anxious about their ability to perform polypectomy should refer their patient to a colonoscopist with more experience. There is no practical downside to piecemeal polypectomy. References 1. Zauber AG, Winawer SJ, O’Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, Shi W, Bond JH, Schapiro M, Panish JF, Stewart ET, Waye JD.