Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Endoscopes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources
PubMedDate not supplied

Diagnosis of portal venous invasion by pancreatobiliary carcinoma: value of endoscopic ultrasonography.

BACKGROUND: We evaluated the usefulness of endoscopic ultrasonography for detecting pancreatobiliary carcinoma and assessing portal venous invasion by carcinoma. METHODS: Seventy-three patients with pancreatic carcinoma (54 patients) or bile duct carcinoma (19 patients) underwent endoscopic ultrasonography, transabdominal ultrasonography, computed tomography (CT), and angiography. All patients underwent tumor resection and histological examination for portal venous invasion. Results of endoscopic ultrasonography were compared with those of other imaging modalities. RESULTS: Histopathology revealed portal venous invasion in 20 patients. Endoscopic ultrasonography was significantly more sensitive (96%) than ultrasonography (81%), CT (86%), and angiography (59%) in detecting carcinomas. On endoscopic ultrasonography, loss of the echogenic vessel-parenchymal sonographic interface or a tumor within the vessel lumen indicated portal venous invasion. For diagnosing portal venous invasion, endoscopic ultrasonography was more sensitive (95%) and accurate (93%) than ultrasonography (55% and 67%), CT (65% and 74%), and angiography (75% and 79%), respectively. CONCLUSION: Endoscopic ultrasonography is the most accurate tool for detecting pancreatobiliary carcinomas and assessing portal venous invasion.

Adult↗
PubMed2005

The evolving role of endoscopic treatment for bleeding esophageal varices.

The treatment of acute and recurrent variceal bleeding is best accomplished by a skilled, knowledgeable, and well-equipped team using a multidisciplinary integrated approach. Optimal management should provide the full spectrum of treatment options including pharmacologic therapy, endoscopic treatment, interventional radiologic procedures, surgical shunts, and liver transplantation. Endoscopic therapy with either band ligation or injection sclerotherapy is an integral component of the management of acute variceal bleeding and of the long-term treatment of patients after a variceal bleed. Variceal eradication with endoscopic ligation requires fewer endoscopic treatment sessions and causes substantially less esophageal complications than does injection sclerotherapy. Although the incidence of early gastrointestinal rebleeding is reduced by endoscopic ligation in most studies, there is no overall survival benefit relative to injection sclerotherapy. Simultaneous combined ligation and sclerotherapy confers no advantage over ligation alone. A sequential staged approach with initial endoscopic ligation followed by sclerotherapy when varices are small may prove to be the optimal method of reducing variceal recurrence. Overall, current data demonstrate clear advantages for using ligation in preference to sclerotherapy. Ligation should therefore be considered the endoscopic treatment of choice in the treatment of esophageal varices.

Endoscopy, Gastrointestinal↗
PubMed2002

Endoscopic surgery in Senegal. Benefits, costs and limits.

BACKGROUND: Evaluating the introduction of endoscopic surgery in Senegal may be useful for assessing the role of this technology in developing countries. METHODS: The endoscopic surgery performed at the Hospital Principal and the Hospital Le Dantec, Dakar, from January 1995 to December 2000 was evaluated retrospectively. Operative time, postoperative stay, patients, and hospital costs were compared in samples of 100 patients treated endoscopically and 80 patients treated with open techniques. RESULTS: Altogether, 826 endoscopic procedures were performed (11.6% of elective surgical activity). Of these, thoracoscopic (34%) and laparoscopic (14%) vagotomy, cholecystectomy (21%), fundoplication (12%), and diagnostic laparoscopy (11%) were selected for comparisons. Operative time proved to be reduced by endoscopic surgery except for laparoscopic fundoplication (+40 min). After endoscopic surgery, postoperative hospitalization was 3.7 days shorter, and patient fees were consequently reduced. In 6 years, 87% of the hospital investment (36,000 Euro) was recovered. CONCLUSIONS: Developing countries can benefit from endoscopic surgery. First-world countries might supply staff training.

Cost-Benefit Analysis↗
PubMed2002

Endoscopic mucosal resection for advanced non-polypoid colorectal adenoma and early stage carcinoma.

PURPOSE: Endoscopic mucosal resection (EMR) techniques were evaluated in the treatment of flat and sessile colorectal neoplasm. PATIENTS AND METHODS: Fifty-seven patients (32 female, 25 male) with non-polypoid colorectal lesions (n = 71, size >or= 10 mm) were included in the study. Tumor location, shape, size, and depth (in malignant lesions) were determined by endoscopy and endoscopic ultrasound. EMR was performed using snare resection, endoscopic aspiration mucosectomy, or EMR using a cap-fitted endoscope. RESULTS: Lesion size ranged from 10 to 50 mm. Complete resection was achieved in 59 of 61 benign and 6 of 8 malignant tumors. Thirty-five tumors were excised in one segment and 34 tumors in piecemeal technique. Pathological examination of neoplasm treated by EMR showed adenoma in 61 and early-stage carcinoma in 8 cases. Because of the non-lifting sign, 2 of 71 tumors were not treated endoscopically and referred to surgical resection revealing a T2 adenocarcinoma in both cases. Resection was incomplete in 2 of 61 adenomas with histological positive resection margin. Complications occurred in 2 patients, with 1 bleeding treated endoscopically and 1 perforation treated by surgery. Local recurrence was observed in 2 of 59 completely resected adenomas and in none of 6 early-stage carcinomas during a mean follow-up of 18 months (range 6 to 30 months). CONCLUSION: Advanced non-polypoid colorectal adenomas and early-stage carcinomas can be safely and effectively resected by endoscopic mucosal resection.

Adenoma↗
PubMed2003

Endoscopic management of stomal stenosis after Roux-en-Y gastric bypass.

BACKGROUND: In the United States, Roux-en-Y gastric bypass has evolved into the procedure of choice for clinically severe obesity. Stomal stenosis resulting in gastric outlet obstruction is a recognized complication. Endoscopic balloon dilation is often used to treat this condition. To evaluate the safety and efficacy of endoscopic management of stomal stenosis we evaluated our treatment methods and outcomes. METHODS: The records of all patients undergoing Roux-en-Y gastric bypass from 1 July 2000 to 30 June 2002 were studied. Stenosis was defined as signs and symptoms of obstruction with inability to cannulate the gastrojejunostomy using an 8.5-mm diagnostic endoscope. Charts were reviewed and demographic data, operative course, symptoms, and outcomes were recorded. RESULTS: A total of 562 patients underwent Roux-en-Y gastric bypass for obesity during the study period. Of these, 38 patients underwent endoscopic balloon dilation for stomal stenosis, for a stenosis rate of 6.8%. The average time from surgery to initial dilation was 7.7 weeks (range 3 to 24). The average number of dilations required was 2.1 (range one to six). The mean initial balloon size was 13 mm and the mean final balloon size was 16 mm. Two patients failed endoscopic dilation and proceeded to surgery, including one patient who developed pneumomediastinum and pneumothorax after dilation. All patients were relieved of their gastric outlet obstruction. The success rate for endoscopic balloon dilation was 95% with a 3% complication rate. CONCLUSIONS: In our experience, the rate of gastrojejunostomy stenosis following Roux-en-Y gastric bypass is 6.8%. Endoscopic balloon dilation is a safe and effective therapy for stomal stenosis with a high success rate. It should be considered an appropriate intervention with a low risk for reoperation.

Adult↗
PubMed1999

Influence of the optical axis-to-target view angle on endoscopic task performance.

BACKGROUND: The location of the optical port and the choice of endoscope determine the angle subtended between the optical axis of the endoscope and the plane of the operation target: the optical axis-to-target view (OATV) angle. The aim of the study was to investigate the influence OATV angle on endoscopic task performance. METHODS: The Dundee Endoscopic Psychomotor Tester was used for objective assessment of endoscopic task performance. Ten surgeons carried out a standard task with the optical axis of the endoscope subtending 90 degrees, 75 degrees, 60 degrees and 45 degrees to the target surface. Each subject underwent three test sessions. Each session consisted of one run with each of the OATV angles in a random order. The outcome measures were the errors rate, the execution time, and the force applied on the target. RESULTS: The 90 degrees OATV angle had the best accuracy, the shortest execution time, and the lowest force applied on the back plate. The errors rate increased from 17% with the 90 degrees OATV angle to 79% with the 45 degrees angle. There was a significant increase in execution time and force with the decrease in the OATV angle (p < 0.0001). CONCLUSIONS: The best task performance is obtained when the optical axis of the endoscope is perpendicular to the target plane.

Analysis of Variance↗
PubMed2005

Organic hyperinsulinism and endoscopic surgery.

BACKGROUND: Experience with minimally invasive surgery for organic hyperinsulinism is limited. No criteria for patient selection with special regard to sporadic, hereditary, multiple and malignant tumors have been defined. METHODS: The estimated success rate of endoscopic surgery was retrospectively calculated by analysing 34 consecutive patients with organic hyperinsulinism operated on by open surgery. A literature search was undertaken to better define indications for endoscopic procedures. Differences in postoperative outcome (morbidity) between endoscopic and open procedures were analysed. RESULTS: Twenty-eight of 31 patients (90%) with solitary insulinomas and one of three patients with multiple insulinomas were correctly localized preoperatively. Twenty-six enucleations (76%) and eight distal resections (24%) including one endoscopic tail resection were performed. Theoretically only 14 out of 34 patients (41%) would have been suitable for endoscopic surgery (8 enucleations and 6 patients for distal resections which were enucleated using an open approach). Pancreatic fistulas were documented in three patients (9%). Reviewing 34 publications, 49 enucleations, 36 distal resections and 15 conversions to open surgery were performed, showing a higher proportion of distal resections in endoscopic surgery. The spleen was preserved in 88% of cases. Fourteen fistulas occurred after enucleations. CONCLUSIONS: Only solitary insulinomas localized in the pancreatic tail or superficially in the body or head may be candidates for endoscopic procedures. Patients with multiple insulinomas, MEN-1 syndrome or malignancy should undergo open surgery.

Endoscopy, Digestive System↗
PubMed2002

Endoscopic Treatment for Gastroesophageal Reflux Disease.

Gastroesophageal reflux disease is a common illness that requires continuous and potentially long-term therapy. Current therapies include long-term acid-reducing medications (most commonly proton pump inhibitors), laparoscopic and open antireflux surgery, and most recently, endoscopic therapies. For the majority of patients with symptomatic GERD, long-term acid-reduction medications are standard therapy. However, endoscopic therapies offer an exciting new avenue for both research and clinical application in persons with gastroesophageal reflux disease. The role of endoscopic therapy in the management of patients with gastroesophageal reflux is still unclear at this time. Its major advantage will be for patients who do not desire long-term medical therapy, particularly those who are on fixed incomes and do not have prescription coverage. The mechanisms by which endoscopic antireflux treatment is effective at this time are uncertain at this time but likely involve a decrease in transient lower esophageal sphincter relaxations that result in decreased acid reflux and potentially in reduced acid sensory stimulation. The anticipated benefits from endoscopic therapy are discontinuance of medications in 30% to 50% of patients at 2 years posttreatment, a reduction in medication use in another 10% to 15% of patients, and avoidance of disruption of the antireflux barrier. The long-term durability of endoscopic treatment is still unknown, although 2-year data appear promising. The role of endoscopic therapy in the treatment of patients with modest hiatal hernias, delayed gastric emptying, atypical symptoms of gastroesophageal reflux, and failed Nissen fundoplication with documented postprocedure reflux remains unclear and requires further study.

Journal Article↗
PubMed2003

Endoscopic Therapy for Inflammatory Bowel Disease.

Endoscopic therapy can be employed and may be useful in inflammatory bowel disease patients with dysplastic polyps, inflammatory strictures (enteric and biliary), bleeding, and for treatment of some complications of continent ileostomies. Dysplastic polyps can be removed endoscopically safely and effectively without resorting to colectomy, as long as there is no other detectable dysplasia in flat mucosa and complete removal can be assured (by biopsy of adjacent mucosa and close follow-up). Some colonic strictures in Crohn's disease can be dilated using endoscopes of graded caliber or with through-the-scope balloons, with or without stent placement. Endoscopy is most useful in dilating anastomotic strictures and less useful for long strictures in active inflammatory disease. Strictures in ulcerative colitis are suspicious for neoplasia and, if dilated at all, should be biopsied extensively and followed closely. We prefer colectomy to endoscopic dilatation for strictures in ulcerative colitis. Biliary endoscopy can be used to dilate strictures in primary sclerosing cholangitis and to sample these areas for malignancy. Although dilatation may improve morbidity and prolong survival, it may not prevent progression to cirrhosis. In cholangiocarcinomas, endoscopic dilatation with or without stents can offer palliation and perhaps be used to deliver photodynamic therapy. Injection and sclerotherapy can be employed in Crohn's disease bleeding from a discrete site. In obstructed continent ileostomies (both Kock pouches and pelvic ileoanal reservoirs), endoscopy can be employed effectively to both determine the cause of the obstruction and re-establish patency. We do not advocate endoscopic treatment of toxic megacolon because of the heightened risk of perforation. Endoscopic therapy of Crohn's fistulas is a possible emerging technology, but it has not been used in large cohorts of patients.

Journal Article↗
PubMed1985

Cardiopulmonary risk of esophagogastroduodenoscopy. Role of endoscope diameter and systemic sedation.

The impact of endoscope diameter and the presence of systemic sedation on the cardiopulmonary risk of esophagogastroduodenoscopy was investigated. One hundred and forty-six patients undergoing elective esophagogastroduodenoscopy were randomly assigned to one of three groups which differed in either endoscope diameter or use of sedation: group 1 (8.5-mm endoscope with no sedation), group 2 (8.5-mm endoscope with diazepam), and group 3 (11.5-mm endoscope with diazepam). Esophagogastroduodenoscopy was tolerated best by group 2, and this group had the fewest electrocardiographic changes observed on a Holter recording during esophagogastroduodenoscopy. The incidence of electrocardiographic changes during esophagogastroduodenoscopy correlated with patient tolerance (p less than 0.001) and the use of the smaller endoscope (p less than 0.05). The most common arrhythmia was sinus tachycardia (49 patients), but more serious electrocardiographic changes were observed in 21 patients. Serious arrhythmias were more common in patients with a prior history of cardiovascular disease compared with patients with no such history (30% vs. 6%, p less than 0.001). Arterial oxygen desaturation (measured by ear oximetry) during intubation and esophagogastroduodenoscopy was usually modest (2%-5%). However, 16 patients receiving diazepam experienced high levels of desaturation exceeding 7%; this small group of patients also experienced more electrocardiographic changes than other patients. The use of diazepam sedation and an 8.5-mm endoscope may offer the safest and most comfortable combination for most patients undergoing esophagogastroduodenoscopy. Diazepam sedation, however, may represent a potential danger to a small number of patients with marginal baseline arterial saturation.

Diazepam↗
PubMed1994

Endoscopic carpal tunnel decompression.

A study of endoscopic carpal tunnel release was carried out in three parts, consisting of initial cadaveric dissections, a prospective pilot study of 20 patients and a prospective, randomized trial of 71 patients comparing endoscopic with open decompression. In the main trial, 25 patients with bilateral symptoms underwent simultaneous endoscopic and open release, with the remainder randomized to one or other technique. Both techniques effectively decompressed the median nerve. A significant improvement in group and pinch strength over 3 months was achieved in those undergoing endoscopic surgery. Average return to work was 14 days in the endoscopic series and 39 days in the open series. A complication rate of 35% was achieved with the transbursal endoscopic technique, 3.7% with the extrabursal endoscopic technique and 13.5% in the open series.

Adult↗
PubMed2006

Complications of endoscopic and open carpal tunnel release.

PURPOSE: To compile the major complications of carpal tunnel surgery and compare reported complications for open and endoscopic techniques. METHODS: A literature assessment was performed for published complications of open and endoscopic carpal tunnel release procedures; 80 publications, representing a period from 1966 through 2001, were reviewed. Complications were identified as neurapraxia; nerve, tendon, or artery injury; and wound infection or dehiscence that required antibiotics or additional operative care. Differences in the proportions of complications between carpal tunnel release procedures were explored with the use of Fisher exact tests. RESULTS: The literature review yielded 22,327 cases of endoscopic carpal tunnel release and 5,669 cases of open carpal tunnel release. For structural damage to nerves, arteries, or tendons, the incidence for open carpal tunnel release is 0.49% and for endoscopic methods (transbursal and extra-bursal), 0.19%. This difference is statistically significant (P < .005; 2-tailed Fisher exact test) and suggests that the overall proportion of structural complications for open carpal tunnel release according to our complication selection criteria is greater than the overall proportion of complications for endoscopic carpal tunnel release. CONCLUSIONS: The proportion of complications for carpal tunnel release, performed through an endoscopic or open approach, is very low. Selection of an open versus an endoscopic approach on the basis of structural complications for nerve, arteries, or tendons is not supported by statistical analysis of published complications. LEVEL OF EVIDENCE: Level III, retrospective comparative therapeutic study.

Carpal Tunnel Syndrome↗
PubMed2006

Endoscopic retrograde dilation of completely occlusive esophageal strictures.

BACKGROUND: Completely occlusive esophageal strictures may develop after head and neck radiotherapy or esophagectomy with gastric or colonic interposition. Major surgical intervention may be required to restore alimentary tract patency when endoscopic lumen reconstitution is not feasible by routine antegrade endoscopy. Retrograde endoscopic lumen identification and dilation is a useful method to reestablish alimentary tract patency, thereby avoiding surgical intervention. METHODS: Patients requiring endoscopic dilation for completely occlusive esophageal strictures were identified by the gastroenterology, thoracic, and head and neck services. Retrograde access was obtained by balloon dilation of either a jejunostomy or gastrostomy tract, and an endoscope was passed to the area of stricture. Antegrade and retrograde endoscopy were performed simultaneously. A guidewire was passed either retrograde or antegrade under direct endoscopic visualization, followed by antegrade Savary dilation under fluoroscopic guidance. RESULTS: From 2003 to 2006, 9 patients were identified with completely occlusive esophageal strictures requiring retrograde lumen identification and dilation. Stricture developed in 6 patients after radiotherapy for head and neck cancer and in 3 after esophagectomy with either gastric or colonic interposition for esophageal cancer. Endoscopic dilation was successful in all patients, without perforation. CONCLUSIONS: Retrograde endoscopic lumen identification and dilation is an option to reestablish lumen patency of completely occlusive esophageal strictures after esophagectomy with gastric or colonic interposition or after head and neck chemoradiotherapy.

Aged↗
PubMed2006

Endoscopic ultrasonography in the diagnosis and management of portal hypertension. Where are we next?

Endoscopic ultrasonography has recently emerged as an accurate, non-invasive and reproducible alternative means of providing data for patients with portal hypertension. It is well established that endoscopic ultrasonography is more sensitive than endoscopy in the diagnosis of gastric varices. Dilated venous abnormalities outside the gastrooesophageal lumen, which cannot be diagnosed by endoscopy, are readily visible with endoscopic ultrasonography or miniature probes. Endoscopic ultrasonography is also useful to predict the risk of variceal recurrence and thus the risk of rebleeding after endotherapy which cannot be reliably predicted using endoscopy alone. The introduction of echo endoscopes equipped with Doppler facilities has allowed the sonographic visualisation of the vessels and the evaluation of vascular blood flow along with possible morphologic and haemodynamic changes after endoscopic or pharmacological therapy. However, despite its theoretical advantages, relative evidence suggests that in the clinical setting of portal hypertension, endoscopic ultrasonography remains an investigational tool with limited clinical applications.

Endosonography↗
PubMed2006

Yield of tissue sampling for subepithelial lesions evaluated by EUS: a comparison between forceps biopsies and endoscopic submucosal resection.

BACKGROUND: In most circumstances, subepithelial tumors lack distinct endoscopic and ultrasonographic features. Consequently, definitive diagnosis usually requires tissue acquisition and pathologic confirmation. Establishing a tissue diagnosis is difficult because the yield of forceps biopsies is low. However, prospective data evaluating tissue sampling techniques for subepithelial lesions are currently lacking. OBJECTIVE: Our purpose was to prospectively determine the diagnostic yield of endoscopic submucosal-mucosal resection (ESMR) compared with forceps biopsy for lesions limited to the submucosa (third endosonographic layer) of the GI tract. DESIGN: A prospective head-to-head comparison was performed. SETTING: The study was performed in a tertiary care hospital. PATIENTS: Study patients were 23 adults with subepithelial lesions limited to the submucosa. INTERVENTION: All submucosal lesions underwent forceps biopsy followed by endoscopic submucosal resection. Biopsy specimens were obtained with large-capacity "jumbo" forceps. A total of 4 double passes (8 biopsy specimens) were collected from each lesion with use of the bite-on-bite technique. Endoscopic resection was then performed with an electrosurgical snare or cap-fitted endoscopic mucosal resection device. MAIN OUTCOME MEASUREMENT: The main outcome measurement was the diagnostic yield of biopsy forceps compared with endoscopic submucosal resection. RESULTS: Twenty-three patients with lesions limited to the submucosa were identified by endoscopic ultrasonography. All lesions underwent forceps biopsy followed by ESMR. The diagnostic yield of the jumbo forceps biopsy was 4 of 23 (17%), whereas the diagnostic yield of ESMR was 20 of 23 (87%) (P = .0001, McNemar test). CONCLUSION: In the evaluation of subepithelial lesions limited to the submucosa, ESMR has a significantly higher diagnostic yield than jumbo forceps biopsy with use of the bite-on-bite technique.

Adult↗
PubMed2006

Success and complications of endoscopic removal of giant duodenal and ampullary polyps: a comparative series.

BACKGROUND: Increasing reports suggest that endoscopic removal of benign ampullary and duodenal polyps is safe and frequently definitive; however, most reported polyps have been small in size (<3 cm). We have developed experience with endoscopic removal of increasingly large and complex polyps. PATIENTS: Fifty-one cases of endoscopic removal were attempted and grouped according to size: group A (n = 22) polyps 1 to 3 cm and group B (n = 29) polyps 3 cm or larger, including 7 cases larger than 5 cm. When the ampulla was involved, biductal sphincterotomy and prophylactic pancreatic duct stent placement was performed first, followed by saline solution-assisted piecemeal polypectomy, argon plasma coagulation, selective endoclip placement, and recovery of all polyp fragments. INTERVENTIONS: Endoscopic removal of duodenal and ampullary adenomas. RESULTS: The outcomes of small and large adenoma removal include mean number of endoscopic retrograde cholangiopancreatographies required for complete removal (2.09 vs 2.56, P = .392), number of complications (4.5% vs 13.9%, P = .375), discovery of unsuspected cancer (0% vs 10.3%, P = .242), and final definitive resolution (100% vs 86.2%, P = .124). Complete removal was achieved in 92.2% of all patients. LIMITATIONS: This was a single center retrospective study. CONCLUSIONS: Large (>/=3 cm) ampullary and duodenal polyps comprised 56.9% of our endoscopically treated cases and present special challenges to definitive endoscopic removal. Successful removal of even very large sessile lesions is possible with minimal increase in risk.

Adult↗
PubMed2004

Endoscopic mandibular condylectomy and reconstruction: early clinical results.

PURPOSE: The purpose of this study was to evaluate early outcomes in patients who underwent endoscopic condylectomy and costochondral graft reconstruction (CCG) of the ramus/condyle unit (RCU). PATIENTS AND METHODS: A retrospective evaluation of 10 consecutive patients who underwent endoscopic condylectomy and CCG (n = 17 sides) for the treatment of idiopathic condylar resorption (n = 7), degenerative joint disease (n = 1), and malunion of a fractured condyle (n = 2) was completed. Patients were included who had 1) adequate documentation after endoscopic condylectomy and CCG reconstruction and 2) a minimum of 6-months follow-up. Patients with inadequate documentation or follow-up were excluded. The surgical technique included a 1.5-cm incision inferior to the mandibular angle. Blunt dissection was carried to the masseter muscle, which was incised using needle point electrocautery. An optical cavity was created for insertion of a Hopkins (Karl Storz, Culver City, CA) endoscope. The resection and reconstruction were carried out with endoscopic instrumentation. Preoperative (T0), postoperative (T1), and follow-up (T2) clinical examinations, lateral cephalograms, and panoramic radiographs were used to evaluate the outcomes. RESULTS: In all 10 cases, condylectomy and CCG reconstruction (n = 17 sides) were successfully performed using the endoscopic approach. The mean follow-up period was 17 months (range, 8 to 38 months). All submandibular scars were aesthetically satisfactory, and there were no facial, inferior alveolar, or lingual nerve injuries. No other intraoperative or postoperative complications occurred. Postoperative RCU length, mandibular position, and correction of the occlusion were documented using lateral cephalometric and panoramic radiographs. CONCLUSION: The results of this study indicate that endoscopic condylectomy and CCG reconstruction produce satisfactory clinical outcomes without significant morbidity. Long-term follow-up studies are in progress.

Adult↗
PubMed2004

Initial experience with an endoscopic radial artery harvesting technique.

OBJECTIVE: The purpose of the study was to investigate the feasibility of an endoscopic radial artery harvesting technique to improve esthetic results and possibly reduce the incidence of neurologic complications observed with the open method. METHODS: Between July 1, 2002, and October 1, 2003, a total of 54 patients underwent endoscopic radial artery harvesting at our institution. Standard endoscopic equipment and a Harmonic Scalpel (Ethicon Endo-Surgery, Inc, Cincinnati, Ohio) were used. Mean age of the patients was 63 +/- 8.1 years, and 16% were female. All patients underwent a preoperative Allen test and duplex ultrasonography to demonstrate adequate ulnar collateral flow. The nondominant arm was used for radial artery harvesting. Mean clinical follow-up was 13 +/- 4.6 months. RESULTS: The artery was harvested through a 3-cm incision at the wrist and was divided at the elbow either through a small counterincision (n = 16) or endoscopically with the use of clips, Endoloop, and endoscopic scissors (n = 38). Mean harvest time was 42.2 +/- 16.9 minutes but decreased from 85 minutes for the first cases to 25 minutes for the last 5 cases. Mean harvested length was 19.6 +/- 1.7 cm. Harvesting complications included 1 conversion, 2 postoperative hematomas, 1 injury, 8 endoscopically controlled bleedings, and 15 cases of at least some superficial radial nerve paresthesia at 6 weeks (clinically relevant in 4 cases). Selective postoperative angiography revealed 1 occluded graft and 1 stenotic graft requiring percutaneous transluminal coronary angioplasty of the native vessel. Eighty-seven percent of the patients were enthusiastic about this new procedure. CONCLUSIONS: Endoscopic radial artery harvesting is a feasible procedure that requires a definite learning curve. Although nerve paresthesias were not completely eliminated in our experience, the technique provided ample patient satisfaction. Further clinical follow-up is required to determine long-term patency rates.

Adult↗