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Create a Free AccountProcedures - Colonoscopy
Endoscopic tacking system as a novel tissue approximation measure for very large EMR defects
Defect closure post-EMR and endoscopic submucosal dissection (ESD) is recommended to decrease the risk of delayed bleeding and perforation. Current methods of tissue approximation and closure of mucosal defects have their limitations, including restricted maneuverability, need for scope withdrawal, or difficulty in apposing larger defects. Through-the-scope HeliX tacking system (Apollo Endosurgery, Austin, Tex, USA) is a novel tissue apposition device designed to mimic suture closure without the need to withdraw the endoscope or insert bulky devices on the tip of the endoscope.Prophylactic appendiceal retrograde intraluminal stent placement (PARIS)
EMR or endoscopic submucosal dissection (ESD) are highly effective methods for resecting colonic polyps1-4 but are ineffective when removing polyps arising from the appendiceal orifice. Endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD; Ovesco, Tuebingen, Germany) is a favorable approach for the management of such lesions because it overcomes the potential risk of perforation or incomplete resection by deployment of an over-the-scope clip (OTSC) beneath the polyp before resection.Endoscopic treatment of colonic diverticular bleeding with an over-the-scope clip after failure of endoscopic band ligation
An 86-year-old woman with a history of hypertension and colonic diverticular bleeding (CDB) presented with severe hematochezia to a nearby medical institution. Contrast-enhanced CT identified extravasation in the sigmoid colon (Fig. 1). Emergency colonoscopy revealed an active diverticular hemorrhage in the sigmoid colon. Although an endoclip was placed on the responsible diverticulum, active bleeding persisted. She was then referred to the emergency department of our hospital.Full-thickness resection of subepithelial nodules, allowing for the diagnosis of an unusual case of pneumatosis cystoides intestinalis
A 61-year-old otherwise healthy man was referred to us for further evaluation of multiple firm, large, subepithelial descending colonic nodules. The area of nodularity was found incidentally on a screening colonoscopy and was located in the descending colon near the splenic flexure. The nodules extended over a length of 5 cm and varied in size from 1 cm to 2.5 cm. One nodule was sampled several times; however, examination of biopsy specimens revealed only colonic mucosa with inflammation and architectural distortion.Endoscopic identification and clipping of an anastomotic leak after colorectal surgery by use of methylene blue dye and over-the-scope clipping system
A 56-year-old woman with high-grade serous ovarian carcinoma who had undergone extensive surgical debulking and rectosigmoid and cecal resection with side-to-side anastomosis presented on postoperative day 14 with sepsis in the setting of a pelvic collection (Fig. 1). An ileocecal leak was identified by a sinogram (Fig. 2) performed with the use of pelvic drains placed by the interventional radiology service, suggesting a postsurgical ileocecal anastomotic leak. After multidisciplinary discussions involving the surgery and interventional radiology services, endoscopic intervention was deemed to be the best minimally invasive approach for closure of this anastomotic leak so the patient could proceed with chemotherapy and radiation afterward.
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