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At least 325 records · Page 18Linked to original sources
PubMed2003

A new endoscopic ureteral reimplantation for primary vesicoureteral reflux (endoscopic trigonoplasty II).

PURPOSE: We describe a new technique of endoscopic antireflux surgery. The principle of the procedure is to make a reliable muscular backing and elongate the intramural ureter. MATERIALS AND METHODS: We performed this new endoscopic surgery in 8 female patients in whom 4, 1, 8 and 1 refluxing ureters (total 14) were diagnosed with grades I to IV reflux, respectively. The operation consists of 3 steps. Two 5 mm. locking trocars are placed into the bladder. Irrigation is done with 3% D-sorbitol solution and the bladder wall is incised upward along each side of the ureter using a resectoscope to make a 2 to 3 cm. U-shaped bladder flap, including the ureter. Under pneumobladder the incised muscle is sutured to make a muscular bed with a needle holder via the urethra and forceps via the abdominal trocar. The U flap is fixed with 2 distal anchor sutures on the embedded muscular layer and 4 additional sutures are placed to approximate the mucosa of the U-shaped flap and bladder. RESULTS: Mean operative time was 245 minutes. Ureteral injury occurred in 2 patients. A Foley catheter remained indwelling for 3 to 5 days (mean 4.1). Reflux resolved in 12 of the 14 ureters (86%) 12 months postoperatively. Vesicoureteral reflux persisted in 1 case because of insufficient fixation and recurred in 1 because of ureterovesical fistula. The patients were satisfied with better cosmesis and minimal postoperative discomfort. CONCLUSIONS: We believe that procedure is feasible for female patients with primary vesicoureteral reflux.

Adolescent↗
PubMed2006

Endoscopic assessment of the dacryocystorhinostomy ostium after endoscopic surgery.

OBJECTIVES: Dacryocystorhinostomy (DCR) is currently regarded as the treatment of choice for treatment of epiphora resulting from blockage at the level of the nasolacrimal duct. There has been debate on the effect of healing on the size of the DCR ostium after surgery. The aim of this study is to determine how the size of the surgically created lacrimal ostium changes over time. STUDY DESIGN: The authors conducted a prospective cohort study of unselected patients who underwent DCR from March 1999 to November 2004. METHODS: Thirty-eight patients who underwent intranasal DCR were analyzed. There were 14 males and 24 females with 11 patients undergoing bilateral DCR, resulting in 49 endoscopic intranasal DCRs being analyzed. The endoscopic findings of the size of the ostia were recorded at the time of surgery and at 4 weeks, 6 months, and 12 months after surgery. There were 33 DCRs reviewed at 12 months and 16 reviewed at 6 months who did not reattend for their 12-month appointment. Analysis of variance was used to compare the difference in the ostium sizes at the end of surgery and at 4 weeks, 6 months, and 12 months after surgery. RESULTS: The male to female ratio was 1:1.7 and the average age was 64.5 (standard deviation [SD]=17.8 years). The ostium measured 11.8 (STD=2.3, 95% confidence interval [CI]=11.1-12.5)x7.2 (SD=1.7; 95% CI=6.7-7.7) at the time of surgery and 10.1 (SD=2.3; 95% CI=9.3-10.9)x6.4 (SD=1.3; 95% CI=6.0-6.9) at 4 weeks, 9.8 (SD=2.5; 95% CI=9.0-10.6)x6.5 (SD=1.5; 95% CI=6.0-6.9) at 6 months, and 10.1 (SD=2.5; 95% CI=9.2-11.0)x6.6 (SD=1.6; 95% CI=6.0-7.1) at 12 months. Statistical analysis (analysis of variance) showed a significant shrinkage from surgery to 4 weeks but no statistical difference from 4 weeks to 6 or 12 months. CONCLUSION: The DCR ostium shrinks a small but significant amount in the first 4 weeks after surgery. Thereafter, the ostium size appears to be stable. We propose that the surgical technique used in which the nasal and lacrimal mucosa is approximated results in a first intention healing with minimal ostial granulation tissue and stenosis and minimal shrinkage of the postoperative DCR ostium.

Dacryocystorhinostomy↗
PubMed2006

Endoscopic mucosal resection for flat neoplasia in chronic ulcerative colitis: can we change the endoscopic management paradigm?

BACKGROUND: The potential of endoscopic mucosal resection (EMR) for treating flat dysplastic lesions in chronic ulcerative colitis (CUC) has not been addressed so far. Historically, such lesions were referred for colectomy. Furthermore, there are only limited data to support endoscopic resection of exophytic adenoma-like mass (ALM) lesions in colitis. AIMS: To evaluate the safety and clinical outcomes of patients with colitis undergoing EMR for Paris class 0-II and class I ALM compared with sporadic controls. Secondary aims were to re-evaluate the prevalence, anatomical "mapping" and histopathological characteristics of both Paris class 0-II and class I lesions in the context of CUC. METHODS: Prospective clinical, pathological and outcome data of patients with colitis-associated Paris class 0-II and Paris class I ALM treated with EMR (primary end points being colorectal cancer development, resection efficacy, metachronous lesion rates and post-resection recurrence rates) were compared with those of sporadic controls. RESULTS: 204 lesions were diagnosed in 169 patients during the study period: 167 (82%) diagnosed at "entry" colonoscopy, and 36 (18%) diagnosed at follow-up. 170 ALMs, 18 dysplasia-associated lesion masses (DALMs) and 16 cancers were diagnosed. A total of 4316 colonoscopies were performed throughout the study period (median per patient: 6; range: 1-8). The median follow-up period for the complete cohort was 4.1 years (range: 3.6-5.21). 1675 controls were included from our prospective database of patients without CUC who had undergone EMR for sporadic Paris class 0-II and snare polypectomy of Paris type I lesions from 1998 onwards, and were considered to be at moderate to high lifetime risk of colorectal cancer. 3792 colonoscopies were performed throughout the study period in this group (median per patient: 4; range: 1-7). The median follow-up period was 4.8 years (range: 2.9-5.2). No statistically significant differences were observed between the CUC study group and controls with respect to age, sex, median number of colonoscopies per patient, median follow-up duration, post-resection complications, median lesional diameter or interval cancer rates. However, there was a significant between-group difference regarding the prevalence of Paris class 0-II lesions in the CUC group (82/155 (61%)) compared with controls (285/801 (35%); chi(2) = 31.13; p<0.001). Furthermore, recurrence rates of lateral spreading tumours were higher in the colitis cohort (1/7 (14%)) than among controls (0/10 (0%); p = 0.048 (95% CI 11.64% to 40.21%)). CONCLUSIONS: Flat DALM, similarly to Paris class I ALM, can be managed safely by EMR in CUC. A change in management paradigm to include EMR for the resection of flat dysplastic lesions in selected cases is proposed.

Adenoma↗
PubMed1982

Endoscopic features of primary small bowel lymphoma: a proposed endoscopic classification.

Primary small bowel lymphoma is relatively common in Middle Eastern countries. Of 29 such cases, proximal small bowel endoscopy was positive in 26 (89.6%) and, on the basis of endoscopy alone, the diagnosis of lymphoma was confidently made in 24 patients (82.7%). The endoscopic biopsy was diagnostic in 19 of the 26 patients with visible mucosal abnormalities (73%). Four types of lesions have been seen on the basis of which an endoscopic classification is being proposed. This classification may be of therapeutic and prognostic value.

Endoscopy↗
PubMed1992

Partial endoscopic middle turbinectomy augmenting functional endoscopic sinus surgery.

Endoscopic sinus surgery has gained acceptance in the otolaryngologic community as an effective and safe method of treating inflammatory disease of the paranasal sinuses. At our institution, partial endoscopic middle turbinectomy has become a standard component of the procedure and our experience is reported. Middle turbinectomy enhances surgical exposure, specific anatomic anomalies are more completely corrected, and subpopulations of patients at risk for failure because of their underlying disease enjoy decreased rates of synechiae formation and closure of the middle meatus antrostomy when followed over time. Photodocumentation of the surgical technique and a discussion regarding the impact of middle turbinectomy on normal nasal physiology are presented. It is reported that the procedure is safe, and no complications directly attributable to middle turbinectomy (including atrophic rhinitis) are reported in a series of 298 patients.

Endoscopy↗
PubMedDate not supplied

[High frequency current in endoscopic surgery and a new bipolar hook for endoscopic surgery].

High frequency current is used in surgery for cutting the tissue and stopping bleeding. Its usage is more frequent in endoscopic than open surgery. "Polarity" (monopolar and bipolar) marks the number of the electrical poles on the application place. Monopolar current has been used more often. With its usage thermal injuries are possible: coagulation outside of the laparoscopic view, direct coupling, capacitive coupling, sparking, skin combustion, activity on the heart rhythm. Because of these complications, the bipolar current is more and more in usage, which reduces the number of complications or avoids them completely. Many bipolar instruments are available today. Bipolar hook for endoscopic surgery is a new instrument which unites the good characteristics of the hook and bipolar current.

Electrosurgery↗
PubMed2001

Endoscopic mucosal resection with a cap-fitted endoscope for early gastric carcinoma with focal submucosal invasion in a patient with decompensated liver cirrhosis.

Prognosis for patients with early gastric cancer who undergo gastric resection is far better than that for patients with advanced disease. However, patients with advanced liver cirrhosis may not be suitable for general anesthesia and major surgery. We used a less invasive endoscopic mucosal resection (EMR) with a cap-fitted endoscope to resect an early gastric cancer in a 58-year-old male with decompensated liver cirrhosis. Although postoperative pathology revealed that the tumor had focal invasion to the submucosa, the patient had an uneventful course and was well during 4 years' follow-up. This method may be effective for the treatment of early gastric cancer with focal submucosal invasion when patients are not suitable for major surgery.

Adenocarcinoma↗
PubMed2003

Development of a new three-dimensional endoscopic ultrasound system through endoscope shape monitoring.

We have developed a new three-dimensional (3D) endoscopic ultrasound system (EUS) with convex scanning echoendoscope to diagnose and navigate for endoscopic puncture using the 3D image. To detect the position of the probe and to monitor the shape of the scope inside the body, we use a fiber optic tracking system which is shaped like a ribbon (Shapetape, Measurand Inc.). The fiber optic tracking system could measure bend and twist at each position of the ribbon. The position of the tip of the echoendoscope is allotted to a 2D image, and the system can reconstruct and visualize a 3D image in real-time. We have reported results of our experimental studies and animal studies.

Endosonography↗
PubMed1991

[Endoscopic surgery of the digestive system: state of the art. Opinion of an endoscopic surgeon].

The Authors review the possible applications of surgical endoscopy in oesophageal, gastric, biliary, pancreatic and colic diseases. This critical assessment, performed under the abdominal endoscopic surgeon's point of view, is based on the overall experience of about 20 years of surgery, with particular regard to the sclerosis of oesophageal varices, neoplastic obstructions of oesophagus, biliary tract, colon and localized Laser treatment of neoplasms. Based on the results achieved, thanks to selective indications and monitoring by conventional surgical experience, the Authors conclude by staging a better reliability of the surgeon who performs surgical endoscopy to obtain good results after an accurate selection of those cases which can really benefit from endoscopic management.

Attitude of Health Personnel↗
PubMed1991

[Combined endoscopic percutaneous drainage and endoscopic biliary lithotripsy in the management of acute cholangitis. First experience in Panama].

Two unusual cases of acute cholangitis are presented. One patient had a 3 cm. common duct stone successfully fragmented with an endoscopic mechanical lithotriptor. The other patient had a hemigastrectomy with a Billroth II anastomosis. A combined percutaneous--endoscopic approach was required to perform the sphincterotomy and remove the duct stones. The different treatment alternatives and the literature are discussed.

Acute Disease↗
PubMed1985

Endoscopic diagnosis of gastric ulcer. Evaluation of the benefits of endoscopic follow-up observation for malignancy.

Examinations at an endoscopy unit in 1976 gave diagnoses of gastric cancer in 31 patients, malignant lymphoma in 3 and new benign gastric ulcer in 223 patients. Correctness of diagnosis was judged to be verified following surgery, autopsy, clinical follow-up or five-year survival. All the malignant lesions were macroscopically and/or microscopically recognized at the first examination, except for one that was then considered to be a submucosal or extragastric tumour, but was correctly diagnosed at surgery prompted by the endoscopic findings. Of the 223 benign ulcers, 219 received a correct diagnosis at the first examination. In the other four cases malignancy was macroscopically or microscopically suspected, but was excluded following surgical excision or repeat examination. Based on these data, the authors suggest that routine endoscopic follow-up of gastric ulcer to exclude malignancy is unnecessary if the primary examination has been performed by an experienced endoscopist, and if both the macroscopic and the microscopic (biopsy) judgement unreservedly are that the lesion is benign.

Adult↗
PubMed1978

[A fast endoscopic test of pancreatic secretion (endoscopic secretin-caerulein-test) (author's transl)].

Measurement of the pancreatic exocrine secretion was performed for 20 minutes using a gastrofiberscope. The exocrine pancreas was stimulated by 1 clin. U./kg secretin and 40 ng/kg caerulein as a bolus injection. Aspiration of duodenal juice was performed by a polyaethylen-tube through the biopsy-channel of the endoscope while duodenum distal of the papilla was shut by a baloon-tube, fixed on the distal end of the gastrofiberscope. In 84 patients the investigation was done 87 times. In 11 cases of proved chronic pancreatitis the endoscopic secretin-caerulein-test (SCKT) was pathologic in each case. --Normal values obtained by SCKT were in the range of those obtained by standard secretin-pancreozymin-test with correction of the volume of duodenal juice. Maximal enzyme output was always found in the first five-minute fraction of duodenal juice. Maximal bicarbonate output was found later between 15 and 20 minutes after stimulation. There was a good correlation between maximal enzyme output and maximal bicarbonate output in SCKT on one side and the results of a standard secretin-pancreozymin-test later performed in the same 10 patients. The SCKT is an easy and fast practicable method to be done after routine gastroscopy.

Ceruletide↗
PubMed1982

Endoscopic removal of an intussuscepted appendix mimicking a polyp--an endoscopic hazard.

A 55-yr-old white woman with a polypoid filling defect in the caput cecum, on barium enema examination, had endoscopic removal of this mass. This was immediately recognized macroscopically to be an intussuscepted appendix. This case is only the second naturally inverting appendix to be removed endoscopically, and it was complicated 18 h later by local peritonitis which was heralded by acute right lower quadrant pain. Laparotomy revealed a cleanly transected base of appendix and cecal adhesions representing previous chronic inflammatory disease. Endoscopists should consider this diagnosis in all cases of mass lesions of the caput cecum. It is imperative to retrieve such lesions if polypectomy is performed, as the macroscopic diagnosis is then evident. Once the diagnosis is established, immediate surgery is advised rather than watchful waiting.

Appendix↗
PubMed1994

An endoscopic and tomographic evaluation of patients with sinusitis after endoscopic sinus surgery and Caldwell-Luc operation: a comparative study.

To evaluate the outcome of surgery using objective methods in patients with sinusitis after endoscopic sinus surgery (ESS) and Caldwell-Luc operation, we randomly selected 37 Caldwell-Luc-operated and 40 ESS-applied cases. Selected patient groups were assessed and compared by endoscopic examination and computed tomography (CT). CT was found to be normal in 12% of Caldwell-Luc-operated sides in comparison to 75% of ESS-applied sides. Endoscopy revealed a patency rate of the windows as 48% in Caldwell-Luc-operated and 86.7% in ESS-applied sides. Fibrosis and abnormal bony changes of the maxillary sinus were encountered in more than half of Caldwell-Luc-operated cases. In conclusion, ESS has a much higher rate of cure compared to the Caldwell-Luc operation if subjective and objective evaluation methods (CT and endoscopy) are applied.

Adolescent↗
PubMed1993

[Endoscopic drainage of pancreatic pseudocyst: endoscopic cysto-enterostomy].

Pancreatic pseudocysts occur in 20% of cases of chronic pancreatitis. Spontaneous resolution is seen in about 9% of the cases, but most cysts persist and frequently cause complications, such as compression of adjacent organs or infection. Endoscopic cysto-enterostomy has recently been reported as a new nonsurgical invasive approach. We present a 40-year-old alcoholic man with a large pancreatic pseudocyst compressing the distal choledochus and pancreatic duct, who was treated successfully by endoscopic cysto-duodenostomy.

Adult↗
PubMed1993

Posterior truncal vagotomy and stapling of the anterior stomach wall in 30 patients with duodenal ulcer: acid inhibition, gastric emptying, and endoscopic dye spraying. Prospects for endoscopic vagotomy.

The use of a stapling instrument (TA90) to effect a transection of the anterior gastric wall with posterior truncal vagotomy but preserving innervation to the anterior wall of the antrum for duodenal ulcer is described. The operation resulted in the endoscopic healing of all the ulcers; however, recurrent ulceration was seen in 3 of 25 patients. Basal acid output was reduced from 7.84 (SEM 1.73) to 3.49 (SEM 1.15) mmol/h (t = 2.09, df = 15.7, p = 0.05), while peak acid output was reduced from 38.67 (SEM 3.11) to 19.26 (SEM 2.3) mmol/h (t = 5.01, df = 23.9, p = 0.0000). Solid and liquid gastric emptying studies were performed, and while some delay in solid emptying was seen, only one patient complained of transient gastric stasis. Endoscopic Congo red staining was performed postoperatively and a tongue of innervated mucosa along the lesser curve was seen in each case. The procedure was easily and rapidly performed, and early clinical results are good, with 25 of 30 patients having a good (Visick I) result.

Adult↗
PubMed1996

Endoscopic abdominoplasty and endoscopically assisted miniabdominoplasty.

Recent developments in abdominal contouring procedures have included the extensive use of liposuction and the use of modified or limited scars, producing in effect a "downsizing" of the operative procedures for many patients. The use of minimally invasive techniques based on endoscopic technology and instrumentation represents a logical extension of this trend. Endoscopic visualization and dissection facilitate musculofascial repair through a very small incision and, combined with liposuction, allows significant improvement in abdominal recontouring in selected patients. Patient selection parameters, instrumentation, operative techniques, and complications of this developing procedure are described.

Abdomen↗