Search results for "Endoscopy"
showing 10 items of 524 documents
Avoiding Complications in Aneurysm Ligation: Operative Tips and Tricks
2022
Preventing possible complications during brain aneurysm surgery is mandatory to ensure a better outcome for patients. Currently, it is possible to rely on some technologic innovations such as motor evoked potential, endoscope-assisted surgery, dye with indocyanine green, and video angiography capable of supporting the surgeon's work. The innovation process has mainly assisted the endovascular technique compared with surgery. The latter, apart from some new technical expedients, always requires anatomic knowledge and optimal technical preparation. A careful patient selection, adequate surgical exposure, use of microsurgical techniques in expert hands, and meticulous postoperative management …
Technique of transanal endoscopic microsurgery.
1988
Sessile adenomas are predominantly localized in the rectum and lower sigma. Surgical removal is indicated but often implies an invasive surgical procedure. Using conventional transanal surgical techniques, only the lower rectum can be reached and there are high rates of recurrence. The new technique combines an endoscopic view of the rectum under gas insufflation via a stereoscopic telescope with conventional surgical preparation and suturing. Adenomas can be excised using the mucosectomy technique or full-thickness-excision, whereas carcinomas should be excised using full-thickness excision with a sufficient border of healthy mucosa. In carcinomas of the sacral cavity, we remove the retror…
Technique and results of the retroperitoneoscopic adrenalectomy via a lumbar approach
1998
Introduction: Since 1992, endoscopic techniques have been used increasingly in adrenal-gland surgery. In the present paper, the technique of the retroperitoneoscopic adrenalectomy via a lumbar approach is described. Methods: The patient is placed in a lateral decubitus position. In the first step, a dilatation trocar is introduced in the retroperitoneal space to create an artificial cavity. The dilatation trocar is replaced by a blocking trocar to close off the operating field. After insufflation of CO2, two additional trocars are introduced in the area of the conventional flank incision. Adrenalectomy is performed via these ports. Once the adrenal gland is completely mobilized, it is inser…
Colonoscopic surveillance in inflammatory bowel disease: state of the art reduction of biopsies.
2011
Longstanding colitis in inflammatory bowel disease (IBD) is associated with an increased risk for intraepithelial neoplasia (IN). White light endoscopy (WLE) with 40–50 random biopsies has been promoted for surveillance but may miss a significant proportion of lesions. In addition, the yield of random biopsies to detect IN is low, and random biopsies are expensive, labor-intensive and distract from scrutinizing the colon. Chromoendoscopy with targeted biopsies has proven its superiority over WLE in multiple randomized trials. It has been incorporated into many national and international guidelines. Virtual chromoendoscopy techniques carry the potential to provide contrast enhancement withou…
Early-stage small-bowel adenocarcinoma: a review of local endoscopic therapy.
2005
Early adenocarcinomas in the small intestine are a rare entity. Most adenocarcinomas in the small intestine are diagnosed at a more advanced stage. After surgical resection, only 3 - 10 % are found in stage T1 and 0 - 3 % in stage Tis (high-grade intraepithelial neoplasia), resulting in an overall 3 - 13 % rate of early-stage small-intestinal adenocarcinomas. The diagnosis of early small-intestinal carcinoma by endoscopy is still very rare, although it will probably improve with the development of new endoscopic techniques. At present there have been only two studies and a few case reports on the treatment of early duodenal carcinoma by endoscopic resection. No major complications such as m…
Gastric cancer in autoimmune gastritis: A case-control study from the German centers of the staR project on gastric cancer research
2020
Objectives Patients with autoimmune gastritis (AIG) are reported to have an increased risk of developing gastric cancer (GC). In this study, we assess the characteristics and outcomes of GC patients with AIG in a multicenter case-control study. Methods Between April 2013 and May 2017, patients with GC, including cancers of the esophagogastric junction (EGJ) Siewert type II and III, were recruited. Patients with histological characteristics of AIG were identified and matched in a 1:2 fashion for age and gender to GC patients with no AIG. Presenting symptoms were documented using a self-administered questionnaire. Results Histological assessment of gastric mucosa was available for 572/759 GC …
Collagenous colitis: new diagnostic possibilities with endomicroscopy
2006
Collagenous colitis is a kind of microscopic colitis. It is characterized by chronic watery diarrhea and abdominal pain. The etiology is still unknown. So far, for the diagnose a histological evaluation was necessary with the presence of thickened subepithelial collagneous bands in the lamina propria. A new developed endoscope with a confocal laser allows analysing cellular and subcellular details of the mucosal layer at high resolution in vivo. In this case report we describe for the first time to diagnose collagenous colitis during ongoing colonoscopy by using this confocal endomicroscopy. In a 67 year old female patient with typical symptoms the characteristic histological changes could …
Italian multicentric survey on laparoscopic spleen surgery in the pediatric population.
2007
Abstract Background: Some technical aspects of laparoscopic spleen surgery still are debated, although efforts have been made to standardize them. The position of the patient, the approach to the spleen, vessel identification and division, and spleen extraction can vary from center to center. Methods: This retrospective muticentric study led by the Societa` Italiana di Videochirurgia Infantile (SIVI) examined indications, surgical details, and complications of laparoscopic spleen surgery in the pediatric population during a 5-year period. Results: The study period from January 1999 to December 2003 (5 years) involved nine centers and included 85 patients with a mean age of 10 years (range, …
The role of Doppler ultrasonography in determining the proper surgical approach to the management of varicocele in children and adolescents
2006
In a study from Italy, colour-Doppler ultrasonography was a reliable diagnostic tool in the preoperative assessment of patients with varicocele. The authors also found that it helped to distinguish those who could be treated laparoscopically from those who should be treated by microsurgical subinguinal ligature. OBJECTIVE To investigate whether colour Doppler ultrasonography (CDUS) is a reliable diagnostic tool for selecting patients with varicocele to undergo either laparoscopy or open microsurgical subinguinal ligation. PATIENTS AND METHODS In a 3-year period, 42 boys affected by left varicocele were evaluated before surgery by inguinal and scrotal CDUS. Using this method it was possible …
Bladder endometriosis: laparoscopic treatment and follow-up
2008
Objectives: This study aims to show the treatment outcome in women affected by isolated bladder endometriosis who underwent laparoscopic surgery in our units. Only women with deep nodules located in the bladder were selected, thus excluding women with deep lesions located in other sites. Study design: Between March 2005 and 2007, women with deep vesical endometriosis, referring to the Departments of Obstetrics and Gynaecology of University Hospitals "G. Martino" of Messina, "Paolo Giaccone" of Palermo and "San Paolo" of Milano, were respectively recruited. A preoperative assessment of the pathology was performed. Women who were concomitantly diagnosed deep nodules of the rectovaginal septum…