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Indian Journal of Ophthalmology Jan 2021Optimal visualization is one of the most challenging aspects of performing vitreoretinal surgery. In situations where conventional microscopic techniques provide poor... (Review)
Review
Optimal visualization is one of the most challenging aspects of performing vitreoretinal surgery. In situations where conventional microscopic techniques provide poor posterior visualization, the adjunctive skill set of endoscopic visualization may be needed. This allows for by-passing the opaque anterior segment media and getting access to the posterior segment pathology. Endoscopic vitrectomy is a useful and unique adjunct to microincision vitreoretinal surgery. The optical set-up of endoscopy allows for clinical approaches that are impossible with regular microscope viewing systems. These include the ability to observe across optically significant anterior segment opacities and directly visualize the posterior segment of the eye. It also allows for visualizing the difficult-to-access retroirideal, retrolental, and anterior retinal structures. Surgical access to anatomic spaces like the pars plana, pars plicata, ciliary sulcus, ciliary body, and peripheral lens is tedious. This is made simpler by endoscopy. In this review, we summarize and review the usage of the intraocular endoscope as a diagnostic and therapeutic armamentarium across a wide spectrum of ocular pathologies.
Topics: Endoscopes; Endoscopy; Humans; Retina; Vitrectomy; Vitreoretinal Surgery
PubMed: 33323565
DOI: 10.4103/ijo.IJO_1029_20 -
IEEE Journal of Translational... 2022In colonoscopy, it is desirable to accurately localize the position of the endoscope's distal tip. Current tip localization techniques are not sufficient for recording...
OBJECTIVE
In colonoscopy, it is desirable to accurately localize the position of the endoscope's distal tip. Current tip localization techniques are not sufficient for recording the position and movement of the tip, nor is its rotation measured. We hypothesize that integration of multiple tracking modalities can effectively record the endoscope's motion in real time and continuously corrects cumulative errors.
METHODS
A dual modality tracking method is developed to measure the motion of the endoscope's insertion tube in real time, including insertion length, rotation angle, and their velocities. Optical trackballs were used to measure the endoscope insertion tube's motion and cameras were used to correct cumulative errors.
RESULTS
The accuracy of insertion length and rotational angle were measured. For speeds ≤ 10 mm/s, the median and 90th percentile insertion position errors were 0.88 mm and 2.2 mm, respectively. The insertion position error increases with the speed, reaching a maximum of 10 mm for speeds < 40 mm/s. 11° and 21° were the median and 90th percentile rotation angle errors for angular speeds < 40°/s. Cumulative errors are sufficiently reduced by the imaging modality.
CONCLUSION
The prototype device can precisely measure an unmodified endoscope's position, rotation, and motion in real time without significant accumulative error. The prototype device is small and compatible with existing commercial endoscopes as an add-on accessory, which could be used for reporting, localizing the lesions in follow up procedures, operational guidance, quality assurance, and training. Clinical and Translational Impact Statement-This preclinical research develops an endoscope tracker that can be integrated into colonoscopy training, automatically record endoscope motion, and be further developed to improve polyp and tumor localization during colonoscopy.
Topics: Humans; Endoscopes; Rotation; Colonoscopy; Movement; Polyps
PubMed: 36457895
DOI: 10.1109/JTEHM.2022.3214148 -
The Surgical Clinics of North America Dec 1990Laparoscopic cholecystectomy is a combined endoscopic-operative technique for removing the gallbladder. Patients with symptomatic gallstones are eligible for this...
Laparoscopic cholecystectomy is a combined endoscopic-operative technique for removing the gallbladder. Patients with symptomatic gallstones are eligible for this procedure. Contraindications include pregnancy, acute cholangitis, advanced cholecystitis, acute pancreatitis, peritonitis, significant bleeding disorder, portal hypertension, and a prior major upper abdominal operation. The procedure does require experience and specialized training. It is guided by an endoscope, camera, and video monitor, and is performed through four cannulas. The gallbladder is dissected from the hepatic bed under observation on a monitor. The possible complications are bleeding, injury to the common bile duct, and technical problems, such as perforation of the gallbladder. The length of the hospital stay and the postoperative recovery time are markedly shortened compared with standard cholecystectomy. The procedure has an advantage over stone dissolution and biliary lithotripsy in that the gallbladder is removed, and additional or continued treatment is not necessary. This procedure offers sufficient advantages to the patient that it will likely become a standard for qualified abdominal surgeons.
Topics: Cholecystectomy; Humans; Laparoscopes; Laparoscopy
PubMed: 2147301
DOI: 10.1016/s0039-6109(16)45282-5 -
BioMed Research International 2022Endoscopic spine surgery (ESS) advances the principles of minimally invasive surgery, including minor collateral tissue damage, reduced blood loss, and faster recovery... (Review)
Review
Endoscopic spine surgery (ESS) advances the principles of minimally invasive surgery, including minor collateral tissue damage, reduced blood loss, and faster recovery times. ESS allows for direct access to the spine through small incisions and direct visualization of spinal pathology via an endoscope. While this technique has many applications, there is a steep learning curve when adopting ESS into a surgeon's practice. Two types of navigation, optical and electromagnetic, may allow for widespread utilization of ESS by engendering improved orientation to surgical anatomy and reduced complication rates. The present review discusses these two available navigation technologies and their application in endoscopic procedures by providing case examples. Furthermore, we report on the future directions of navigation within the discipline of ESS.
Topics: Endoscopes; Endoscopy; Minimally Invasive Surgical Procedures; Spine
PubMed: 36072476
DOI: 10.1155/2022/8419739 -
Panminerva Medica Sep 2019In clinical practice, interventional pulmonologists face several situations which can lead to dramatic consequences especially regarding ventilation and require... (Review)
Review
In clinical practice, interventional pulmonologists face several situations which can lead to dramatic consequences especially regarding ventilation and require immediate intervention. We describe the main pathological conditions where an urgent bronchoscopy is crucial because they act through mechanisms such as airway obstructions or alteration of the anatomic integrity of the tracheobronchial tree. We point out the problems resulting from inhalation of foreign bodies, one of the most dramatic respiratory emergencies typical in childhood which needs not only the appropriate endoscopic equipment suitable for the age, but also great experience in the management of the possible related complications. Massive hemoptysis is then discussed in order to help to choose the right endoscope and to clarify the steps requested to face this dramatic event. Lastly, iatrogenic tracheal injuries are described, in spite of their low occurrence. The correct endoscopic assessment of the lesions enables to select the proper multidisciplinary therapeutic approach together with surgeons and anesthetists. Due to their peculiarities, emergencies do not allow classic training so it is difficult to estimate the procedure volume necessary to achieve an adequate endoscopic experience. We think, in this field, it is advisable to refer to numbers proposed for elections endoscopic procedures. For these reasons, we consider desirable the use of simulators and clinic case discussions during interventional pulmonologist's training.
Topics: Bronchoscopes; Bronchoscopy; Clinical Competence; Emergencies; Emergency Medicine; Endoscopy; Foreign Bodies; Foreign-Body Reaction; Hemoptysis; Humans; Inhalation; Pulmonary Medicine; Treatment Outcome
PubMed: 30303356
DOI: 10.23736/S0031-0808.18.03543-7 -
Acta Cirurgica Brasileira 2020Purpose To present new endoscopic robotic devices in the context of minimally invasive procedures with high precision and automation. Methods Review of the literature by... (Review)
Review
Purpose To present new endoscopic robotic devices in the context of minimally invasive procedures with high precision and automation. Methods Review of the literature by December 2018 on robotic endoscopy. Results We present the studies and investments for robotic implementation and flexible endoscopy evolution. We divided them into forceps manipulation platforms, active endoscopy and endoscopic capsule. They try to improve forceps handling and stability and to promote active movement. Conclusion The implementation and propagation of robotic models depend on doing what the endoscopist is unable to. The new devices are moving forward in this direction.
Topics: Animals; Endoscopes; Endoscopic Mucosal Resection; Endoscopy; Equipment Design; Humans; Minimally Invasive Surgical Procedures; Models, Animal; Robotic Surgical Procedures; Surgery, Computer-Assisted; Surgical Instruments
PubMed: 32348403
DOI: 10.1590/s0102-865020200020000006 -
Journal of Nippon Medical School =... 2021With advancements in the development of flexible endoscopes and endoscopic devices and the increased demand for minimally invasive treatments, the indications of... (Review)
Review
With advancements in the development of flexible endoscopes and endoscopic devices and the increased demand for minimally invasive treatments, the indications of therapeutic endoscopy have been expanded. Methods of endoscopic treatment used for tissue removal, hemostasis, and dilatation are as follows. Endoscopic submucosal dissection (ESD) is considered the gold standard curative method for removal of gastrointestinal node-negative neoplasms, regardless of their size or the presence of ulcer formation. Laparoscopic endoscopic cooperative surgery (LECS), which incorporates ESD, was introduced for removal of lesions in deeper layers. Another technique is endoscopic full-thickness resection, which is challenging without the assistance of laparoscopy. In terms of hemostasis, management of iatrogenic bleeding after endoscopic treatment is an important issue. Shielding methods and suturing techniques have been introduced for large mucosal defects after ESD, and their efficacy has been investigated clinically. Peroral endoscopic myotomy (POEM) is a new alternative surgical approach for minimally invasive treatment of esophageal achalasia. Furthermore, endoscopic fundoplication after POEM was devised to prevent post-POEM gastroesophageal reflux disease. Many endoscopic treatments, including ESD, LECS, and POEM, have been introduced in Japan. With the aging of the population, more attention will be directed toward therapeutic endoscopy for elderly patients, because it is less invasive. Development of endoscopic treatments with expanded indications is expected.
Topics: Endoscopes, Gastrointestinal; Endoscopy, Gastrointestinal; Esophageal Achalasia; Female; Fundoplication; Gastric Mucosa; Gastroesophageal Reflux; Gastrointestinal Neoplasms; Hemostasis, Endoscopic; Humans; Laparoscopy; Male; Myotomy; Postoperative Complications; Postoperative Hemorrhage
PubMed: 33692281
DOI: 10.1272/jnms.JNMS.2021_88-109 -
JSLS : Journal of the Society of... 2019The patients who underwent endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for mucosal and submucosal lesions of the esophagus, stomach,...
AIM
The patients who underwent endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for mucosal and submucosal lesions of the esophagus, stomach, and duodenum and the advantages of the double endoscope method we used for traction during ESD were evaluated.
MATERIAL AND METHODS
The patients who underwent ESD and EMR due to upper gastrointestinal lesions were evaluated retrospectively between January 2014 and April 2018 in our endoscopy unit.
RESULT
The mean age of 10 patients with esophageal lesions was 53 years. ESD was performed for 7 lesions and EMR for 3 lesions. The most common lesion was leiomyoma and the median size of the lesions was 1.4 cm (range, 0.6-2.5 cm).The median age of 26 patients with gastric lesions was 61 years. EMR were performed for 11 lesions and ESD for 15 lesions. Double endoscope was used in 6 patients. One patient had intramucosal carcinoma, while the other lesions were benign and dysplasia was the most common lesion. The median size of lesions was 1.8 cm (range, 1-3 cm).All lesions were evaluated with endoscopic ultrasonography. Bleeding was seen in 4 patients and perforation in 1 patient during ESD and defect was closed with endoscopic clips.
CONCLUSION
The advantages of endoscopic resections; short hospitalization, low complication rates, patient comfort, and doesn't require the general anesthesia. For endoscopic resection, we think that the second endoscope shortens the duration of the procedure, reduces the complication rate, and increases the comfort of the endoscopist.
Topics: Adult; Aged; Dissection; Endoscopes; Endoscopic Mucosal Resection; Equipment Design; Female; Gastrointestinal Diseases; Humans; Male; Middle Aged; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 30880899
DOI: 10.4293/JSLS.2018.00096 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Aug 2023More than 30 years of rapid development of endoscopic surgery has led to the mainstreaming of this procedure in many surgical departments in China. Since the first...
More than 30 years of rapid development of endoscopic surgery has led to the mainstreaming of this procedure in many surgical departments in China. Since the first report on endoscopy, it has been used in salivary gland resection for more than 20 years. The overall development of endoscopic surgery indicates that its use in oral and maxillofacial surgery is still in the early exploration stage; it has not yet been maturely developed or applied. Owing to the advancement of other disciplines and corresponding widening experiences in those fields, the development of endoscopic technology in oral and maxillofacial surgery will likely achieve a leapfrogging. Learning from the general development pattern of endoscopy, this research explores the application history, current situation, and future direction of the application of endoscopy in salivary gland surgery.
Topics: Endoscopy; Endoscopes; Salivary Glands; China
PubMed: 37474469
DOI: 10.7518/hxkq.2023.2023116 -
Zeitschrift Fur Gastroenterologie Sep 2022A disposable upper gastrointestinal endoscope can effectively decrease infectious outbreaks associated with endoscope reuse. In the present study, we aimed to evaluate... (Randomized Controlled Trial)
Randomized Controlled Trial
The feasibility and safety of disposable endoscope vs. conventional endoscope for upper gastrointestinal tract examination: a multicenter, randomized, parallel, non-inferiority trial.
BACKGROUND
A disposable upper gastrointestinal endoscope can effectively decrease infectious outbreaks associated with endoscope reuse. In the present study, we aimed to evaluate the feasibility and safety of a disposable endoscope for upper gastrointestinal examination.
METHODS
In a prospective, randomized trial, 144 upper endoscopic procedures were allocated to either the disposable endoscope group or the conventional endoscope group. The primary outcomes were rates of excellent and good image qualities and maneuverability satisfaction. The second outcome included procedure duration, endoscopic diagnosis, and adverse events.
RESULTS
A total of 144 subjects were enrolled in the present analysis and prospectively randomized to 2 study groups. Finally, 70 and 69 subjects were enrolled in the novel disposable endoscope group and the conventional endoscope group, respectively, due to the schedule cancellation of 5 subjects. The baseline characteristics of the patients were similar in both groups. The excellent and good image quality rates and maneuverability satisfaction of the novel disposable endoscope were not inferior to the conventional endoscope (p = 0.99 and p = 0.99, respectively). Moreover, no significant between-group difference was observed in the endoscopic results and adverse events (p = 0.30 and p = 1, respectively). However, the procedure duration in the novel disposable endoscope was longer compared with the conventional endoscope (8.40 ± 4.28 min 5.12 ± 2.65 min, p < 0.001).
CONCLUSIONS
The novel disposable endoscope was as safe, effective, and maneuverable as a conventional endoscope. However, the novel disposable endoscope was associated with a longer procedure duration.
Topics: Endoscopes; Endoscopy, Gastrointestinal; Feasibility Studies; Humans; Prospective Studies; Upper Gastrointestinal Tract
PubMed: 34768288
DOI: 10.1055/a-1555-0568