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PubMedDate not supplied

[Endoscopic treatment of perforating veins--current data].

Blind dissection of incompetent perforators is common practice for vein surgeons. Since many years some of them have been trying to do this endoscopically by means of the proctoscope or other endoscopes used for different purposes. At present however several surgeons are developing special instruments for this type of endoscopy. Lately some of these surgeons came together to work up their experiences and to study the probable future of the method. It permits the diagnosis and at the same time the treatment of incompetent perforators. It allows the healthy ones to be spared. All this can be done from a small incision distant to the site of the perforators where the skin often presents with trophic changes. However general or regional anesthesia as well as the bloodless limb technique are prerequisites. As any endoscopy also this one has its specific dangers and complications and therefore has to be learned and performed carefully.

Angioscopes↗
PubMed1993

[Endoscopic perforant vein revision. Current status].

Blind dissection of incompetent perforators is common practice for vein surgeons. Since many years some of them have been trying to do this endoscopically by means of the proctoscope or other endoscopes used for different purposes. At present, however, several surgeons are developing special instruments for this type of endoscopy. Lately some of these surgeons came together to work up their experiences and to study the probable future of the method. It permits the diagnosis and at the same time the treatment of incompetent perforators. It allows the healthy ones to be spared. All this can be done from a small incision distant to the site of the perforators where the skin often presents with trophic changes. However, general or regional anesthesia as well as the bloodless limb technique are prerequisites. As any endoscopy also this one has its specific dangers and complications and therefore has to be learned and performed carefully.

Angioscopes↗
PubMed1996

State- and sex-specific prevalence of selected characteristics--Behavioral Risk Factor Surveillance System, 1992 and 1993.

PROBLEM/CONDITION: Much chronic disease and injury morbidity and mortality is associated with high-risk behaviors (e.g., cigarette smoking, excessive alcohol consumption, and physical inactivity) and with lack of preventive health care (e.g., screening for cancer). States use the Behavioral Risk Factor Surveillance System (BRFSS) to collect data about these modifiable health behaviors and to monitor trends and significant changes in their populations over time. REPORTING PERIOD: 1992 and 1993. DESCRIPTION OF SYSTEM: The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (persons > or = 18 years of age) population. In 1992, 48 states and the District of Columbia participated in the BRFSS; in 1993, 49 states and the District of Columbia participated. Several questions were added to the BRFSS in 1993. RESULTS: As in previous years, state-specific variations occurred in the prevalence of high-risk behaviors, awareness of certain medical conditions, use of preventive health services, and health-care coverage. In 1993, 4.0% (range: 1.4% - 6.4%) of adults reported riding with a driver who had had too much alcohol to drink. The percentage of persons > or = 50 years of age who had ever had a proctoscopic examination ranged from 25.6% to 51.5% (median: 36.8%). Among adults > or = 65 years of age, 27.4% (range: 18.5 % - 40.0%) had ever had a pneumococcal vaccination, and 49.9% (range: 28.7% - 66.2%) had had an influenza vaccination within the past 1 year. INTERPRETATION: The variations in prevalence across states likely reflect socioeconomic differences, differences in state laws enacted to discourage risky behaviors, different levels of effort to screen for certain types of cancer or risk factors for other diseases, and other factors. ACTION TAKEN: States will continue to use the BRFSS to collect data about health behaviors. Analysis of these data will enable states to monitor factors that may affect the rate of chronic disease and injury mortality and morbidity and to develop public health policies to address these problems.

Adult↗
PubMed1977

Fiberendoscopy of the gastrointestinal tract in children. A series of 100 examinations.

This article reports the results of our first 100 examinations of the upper gastrointestinal tract and the colon in children and infants, using standard fiberscopes and also pediatric models. The procedure could be performed under sedation in 80% of the cases and general anesthesia was required mainly with standard fiberscopes. Compared to roentgenographic findings, fiberendoscopy proved to be more reliable in superficial mucosal lesions and gastrointestinal bleeding. Colonoscopy though difficult, is valuable in diagnosing rectal bleeding lesions and as a follow-up technique in inflammatory bowel diseases.

Abdomen↗
PubMed1992

[Endoscopic therapy of benign anastomotic stenoses in the area of the colon and rectum by electro-incision and balloon dilatation].

21 patients with a severe anastomotic stenosis in the colorectal region were treated with hydraulic balloon dilatation and endoscopic electro-incision. The severity of symptoms directly correlates with the extent of stenosis (degree I phi 13 mm, n = 12; degree II phi 7 mm, n = 6; degree III phi 4 mm, n = 3). All patients with a stenosis of degree I and II were symptom-free after the endoscopic therapy. In 2 of 3 cases the symptoms of stenosis of degree III could clinically be improved after the treatment. The average frequency of dilatation was 1.5 x, complications such as bleeding or perforation were not registered. Animal studies explain anastomotic stenosis through an increased submucosal formation of collagen fibers followed by formation of scars in the anastomosis. The efficiency of electro-incision and balloon dilatation is based on an increased diameter in the anastomotic region without increased formation of new collagen fibers.

Adult↗
PubMed1996

Is transanal endoscopic microsurgery (TEM) a valid treatment for rectal tumors?

BACKGROUND: In 1983 G. Buess, in Germany, developed transanal endoscopic microsurgery (TEM), a new minimally invasive technique for the treatment of rectal tumors. METHODS: Rectal lesions are excised through a modified rectoscope of 40 mm in diameter under stereoscopic control in the gas-dilated rectal cavity. Full-thickness excision, partial-wall excision, or mucosectomy can be performed. Seventy-one patients were treated with the TEM technique in our department. Major complications were observed in one patient (1.4%). No mortality was reported. RESULTS: Histological examination revealed 40 (56.3%) villous adenomas, 6 (8.4%) pT1; 17 (23.9%) pT2; 5 (7%) pT3 carcinomas; and 3 ((4.2%) other lesions. The recurrence rate was 2.8% for adenomas and 2.8% for carcinomas. The overall survival at mean follow-up of 17 months was 96.4%. CONCLUSIONS: The advantages of TEM are less or no postoperative pain, unrestricted mobility, short hospitalization, quick rehabilitation, and absence of skin scars.

Adenoma, Villous↗
PubMed1991

[Endosonography in preoperative staging of gastrointestinal tumors].

29 patients with esophageal and gastric tumors, and 109 patients with rectal carcinoma were preoperatively investigated by endosonography. Tumor infiltration and lymph node spreading were assessed by endosonography and compared to the postoperative histological findings. Depth of tumor infiltration was assessed correctly in 88% of all patients investigated. Lymph node spreading of gastric and esophageal cancer was detected in 84%. In contrast lymph node metastases of rectal carcinoma were rarely seen. The high accuracy of endosonography in detection of lymph node metastases of esophageal cancer makes it possible to select the appropriate treatment, such as surgery, radiotherapy or palliative procedures. Endorectal sonography is a powerful tool to select those patients, who can only be treated by local excision.

Endoscopes, Gastrointestinal↗
PubMed1991

Disposable torch-lit anoscope.

A disposable torch-lit anoscope is described. Its bevelled end facilitates therapeutic procedures, while the fact that it does not need an external light source makes its use on the ward or in the patient's home more straight-forward.

Anal Canal↗
PubMed1988

Technique of transanal endoscopic microsurgery.

Sessile adenomas are predominantly localized in the rectum and lower sigma. Surgical removal is indicated but often implies an invasive surgical procedure. Using conventional transanal surgical techniques, only the lower rectum can be reached and there are high rates of recurrence. The new technique combines an endoscopic view of the rectum under gas insufflation via a stereoscopic telescope with conventional surgical preparation and suturing. Adenomas can be excised using the mucosectomy technique or full-thickness-excision, whereas carcinomas should be excised using full-thickness excision with a sufficient border of healthy mucosa. In carcinomas of the sacral cavity, we remove the retrorectal fat up to the fascia of Waldeyer, including the regional lymph nodes. Transanal endoscopic microsurgery is the most economical and tissue-saving surgical technique for the removal of rectal adenomas and early rectal carcinomas.

Adenoma↗
PubMed1993

Hinged anoscope.

A hinged anoscope for insertion of rectal catheters is presented. Catheters attached to or integrally part of an external monitoring device or collecting system can be inserted through this endoscope. The endoscope can be removed without disconnecting the catheter from the external device.

Equipment Design↗
PubMed1995

Anoscopic-assisted insertion of end-to-end anastomosing staplers.

Widespread popularity of the double-stapler technique has created the potential for anal sphincter and anal canal injury during transanal insertion of the end-to-end anastomosing stapler. The Faensler operating anoscope helps eliminate that potential by symmetrically dilating the anal canal, thereby permitting atraumatic insertion of the end-to-end anastomosing stapler.

Anal Canal↗
PubMed1992

Transanal endoscopic microsurgery.

Transanal endoscopic microsurgery (TEM) has emerged as a minimally invasive means of resecting rectal tumors. Developed in Germany and now being used with increasing frequency in the United States, TEM utilizes a 40-mm operating rectoscope, which is sealed with an airtight facepiece. Carbon dioxide is constantly infused, thereby distending the rectum and maintaining visibility. A variety of instruments, such as tissue graspers, a high-frequency knife, suction, and needle holders, are inserted through the facepiece. Adenomas that are small, large, or even circumferential, as well as selected carcinomas up to 24 cm, can be removed with TEM instrumentation. The optics provide sixfold magnification, and this, combined with the constantly distended operative field, allows for a precise excision of the tumor as well as closure of the wound. For lesions in the mid and upper rectum, TEM is an alternative to a transsacral or transabdominal approach, with subsequently shorter hospital stay and fewer complications.

Adenoma↗
PubMed1992

Open sesame: tips for traversing the anal canal.

The key points for a minimally traumatic and pain-free anal intubation are an informed patient, gentle technique, plenty of lubricant, a relaxed, supportive atmosphere, and gradual inward pressure on the instrument or finger. Also important are knowledge of the direction of the anal canal, sideways introduction of the flexible endoscope, and the technique of gaining anal relaxation by asking the patient to push down.

Anal Canal↗
PubMedDate not supplied

Sclerotherapy of internal hemorrhoids using newly devised transparent disposable anorectoscope.

We devised a transparent anorectoscope for internal hemorrhoidal sclerotherapy. Using this scope the grade of hemorrhoids of the patients can be evaluated accurately through the transparent wall of the scope, and the device facilitates easier and safer sclerotherapy under clear direct vision, compared to the conventional free-hand-style treatment. We conclude that sclerotherapy using this anorectoscope represents a minimally invasive treatment for low-grade internal hemorrhoids and is recommendable for outpatient therapy of internal hemorrhoids.

Disposable Equipment↗
PubMed1983

Flexible fiberoptic sigmoidoscopy--the Monroe Clinic experience. A prospective study of 5000 examinations.

Analysis of 5000 consecutive flexible fiberoptic sigmoidoscopies form the basis of this report. It is concluded that this method of examination of the distal large bowel is not only safe and comfortable for the patient but is a more appropriate examination than the rigid proctosigmoidoscopy because of the significant increase in pathologic material found. This examination has proven practical and acceptable in a multispecialty clinic setting and has completely replaced rigid proctosigmoidoscopy. Flexible sigmoidoscopy is now the standard "routine" examination of the rectum and distal colon. The rationale for this conclusion is presented in this timely report.

Adolescent↗