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Create a Free AccountProcedures - Endoscopic submucosal dissection (ESD)
Endoscopic transcecal appendectomy under laparoscopic single-port assistance
A 72-year-old man was detected as having a flat-elevated tumor located in the appendix, measuring 15 mm in diameter (Fig. 1A). The lesion completely covered the appendiceal orifice, and the edge of the lesion could not be visualized (Fig. 1B). Because patients usually want minimally invasive treatments, endoscopic transcecal appendectomy was scheduled after the patient provided informed consent. It is our strategy to use a single port to introduce the laparoscope and confirm the condition around the appendix, to guide the endoscope safely, and to endoscopically resect the lesion and close the defect.Continuous saliva suction tube to prevent aspiration pneumonia during upper GI endoscopy
Endoscopic submucosal dissection (ESD) has been established as a minimally invasive treatment modality and has been adopted worldwide for the treatment of early GI tract cancer. However, aspiration pneumonia, a sedation-related adverse event, is reportedly detected on postoperative CT images in 32.0% of cases after esophageal ESD1 and 6.6% to 14.4% of cases after gastric ESD.2,3 Clinical symptoms in the majority of patients are often mild, but symptoms can become serious in elderly patients. Furthermore, because the number of endoscopic treatments for elderly patients is expected to continue to increase in the future, a new strategy is needed to prevent aspiration pneumonia associated with liquid reflux and saliva retention in the oral cavity.Usefulness of a thin-endoscope endoscopic submucosal dissection using the traction device for early gastric cancer in a patient with esophageal stricture
Use of endoscopic submucosal dissection (ESD) for early gastric cancer has become widespread. However, the conventional endoscope sometimes cannot be used for reasons such as the presence of a stricture. Previously, endoscopic resection could be performed only after dilatation (eg, balloon) to treat the stricture, but this has the risk of adverse events (eg, perforation and bleeding).1 We report successful ESD for early gastric cancer using a thin endoscope.Usefulness of a handmade distal endoscope attachment with a transparent tape
Distal attachments placed on the endoscope tip can improve visualization of the endoscopic field and have been applied for a variety of endoscopic procedures (eg, colonic insertion, detection, diagnosis, and treatment).1 Although manufactured distal attachments are commercially available, it may be necessary to prepare different types to suit different endoscopes because the distal outer diameters of endoscopes vary widely. In addition, cost-effectiveness leads to hesitation about the use of commercially available distal attachments in daily practice.Multiloop method for traction during colorectal endoscopic submucosal dissection
Colorectal endoscopic submucosal dissection (ESD) is one of the most challenging procedures. Traction methods for colorectal ESD have been devised to simplify the procedure and reduce the risks of adverse events.1-5 However, several problems remain, especially in terms of versatility and convenience. Therefore, we have devised a multiloop (M-loop) method, which is a traction method using silk thread and clips.
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