Advanced Colonoscopy and Endoluminal Surgery

 

Description:

Each chapter of this new book on advanced lower GI endoscopy and endoluminal surgery focuses on the thought process and step-wise technical approach to the condition and procedure listed.  By using this unique method, practitioners ranging from surgeons-in-training, gastroenterologists-in-training and those early in their career to senior colorectal specialists and gastroenterologist who want to incorporate or improve their advanced endoscopic skills will be able utilize techniques and learn from this gathering of experts. The guiding principle of this work is to create a resource for surgeons and gastroenterologists that extends beyond the currently available texts, and that surgeons and gastroenterologists can turn to when wanting to “brush up” on techniques, find a useful “tip or trick” for a complex patient, or simply learn a reproducible methods for advanced endoscopic procedures. This unique book highlights current knowledge, demonstrates standards of medical care, and provides clear step-by-step reproducible techniques even for the most advanced procedures.  Beyond the simple application of technical knowledge the book addresses the deeper questions about the optimal “next step” in dealing with more complex patients (i.e., difficult polyps, gastrointestinal bleeding, IBD). International experts also address future challenges and innovations in lower gastrointestinal endoscopy.   Finally, it focuses on specific “tips and tricks” that experts in the field have learned. The format follows that of both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. Throughout the text, each author provides an ongoing narrative of his/her individual techniques along with color illustrations and diagrams to “personally” take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic.  Additionally, where appropriate, links to online videos will give the reader an up-front look into technical aspects of EMR, ESD, endoscopic stent placements, CELS, as well as NOTES. The editors and contributors to this book are those with nationally and internationally recognized expertise in lower gastrointestinal endoscopic and endoluminal interventions, have taught many international courses, and have numerous peer-reviewed publications. This book will be useful to colorectal surgeons, general surgeons, and gastroenterologists who want to learn or improve their skills in lower gastrointestinal endoscopy and advanced endoscopic interventions. Furthermore, this book will be of particular interest to the surgeons-in-training, and gastroenterologist-in-training that are often called upon to manage a variety of colorectal conditions through an endoscopic approach.  This would ultimately serve as an invaluable reference for any physician or surgeon with a vested interest in caring for patients with simple or complex colorectal disease.

 

 

Table of Contents:

 

1: History of Colonoscopy

Key Points

Bozzini and the Lichtleiter

Evolution of Upper Gastrointestinal Endoscopy

Early Advances

Semiflexible Endoscopes

Fiber-Optic Endoscopy

Development of the Colonoscope

Early Lower Gastrointestinal Endoscopy

The First Colonoscopies

Endoscopic Photography

Video Endoscopy

The Modern Colonoscope

The Colonoscope as a Therapeutic Instrument

Endoscopic Resection of Early-Stage Malignancies

Transanal Techniques

Colonic Stenting

Conclusions

References

2: Anatomic Basis of Colonoscopy

Key Points

Background

Anatomic Variations

Mural Findings and Internal Cues Helpful in Advancement

Positioning

Looping

Reduction of Loops

Anatomy

Anus

Rectum

Key Landmarks

Rectosigmoid and Sigmoid Colon

Key Landmarks

Descending Colon

Splenic Flexure

Key Landmarks

Transverse Colon

Key Landmarks

Hepatic Flexure and Ascending Colon

Key Landmarks

Cecum/Ileocecal Valve/Appendiceal Orifice

Key Landmarks

Terminal Ileum

Anorectal Canal

Key Landmarks

Pearls and Pitfalls

Conclusion

References

3: Colonoscopy Photo Atlas

Normal Anatomy

Pathology

Postoperative Anatomy

4: How to Achieve High Rates of Bowel Preparation Adequacy

Key Points

Introduction

Types of Bowel Preparations

Administration

Criteria for More Aggressive Bowel Preparation

Types of More Aggressive Preparations: Two-Day Preps/Types

Techniques for Salvaging Inadequate Preparations

Cleansing Scales Appropriate for Clinical Practice

Pearls and Pitfalls

Summary

References

5: Patient Comfort During Colonoscopy

Key Points

Introduction

Current Sedation Practices for Colonoscopy

Unsedated Colonoscopy

Propofol Versus Benzodiazepine +/− Opioid

Opioids Alone

CO2 Insufflation Colonoscopy

Water-Aided Colonoscopy

Other Procedural Adjuncts to Colonoscopy

Magnetic Endoscope Imaging

Type of Colonoscope

Patient Position

Medications

Conclusion

Pearls and Pitfalls

References

6: VTE Prophylaxis: How to Optimize Patients on Anticoagulation and Avoid Infectious Complication

Key Points

Introduction

Anticoagulation and Colonoscopy

Anticoagulants

Bleeding Risk

Thromboembolic Risks

Classes of Medications

Aspirin

Non-aspirin Antiplatelet Drugs

Current Guidelines

Inhibitors of ADP-Induced Platelet Aggregation (Clopidogrel and Ticlopidine)

Glycoprotein IIb/IIIa Receptor Blockers (Abciximab, Tirofiban, and Eptifibatide)

Warfarin

Novel Oral Anticoagulants (NOACs): Factor X and Thrombin Inhibitors

Risk of Hemorrhage

Antibiotic Prophylaxis After Colonoscopy

Prevention of Endocarditis

Peritoneal Dialysis

Other Conditions

References

7: Endoscopic Equipment and Instrumentation

Key Points

Colonoscopes

Biopsy Equipment

Tattoo

Endoscopic Mucosal Resection (EMR)

Endoscopic Submucosal Dissection (ESD)

Chromoendoscopy

Narrow Band Imaging (NBI) and Multiband Imaging (MBI)

Confocal Laser Endomicroscopy (CLE)

References

8: Basic Colonoscopic Techniques to Reach the Cecum

Key Points

Introduction

Preprocedure Preparation

Technique of Insertion

Tip Deflection

Torque

Push/Pull

Slide-by

Jiggle

Hooking

Suction

Irrigation

Intubation of the Terminal Ileum

Challenges to Colonoscope Insertion

Adjuncts to Colonoscope Insertion

When All Else Fails

Conclusion

References

9: Basic Colonoscopic Interventions: Cold, Hot Biopsy Techniques, Submucosal Injection, Clip Applica

Key Points

Introduction

Indications

“Cold” Forceps Polypectomy/Biopsy

“Hot” Forceps Polypectomy/Biopsy

Submucosal Injection

Clip Application

Snare Polypectomy/Biopsy

Pearls and Pitfalls

References

10: Current Guidelines for Colonoscopy

Key Points

Introduction

Concept of CRC Screening and Surveillance vs. Diagnostic Workup

Indications for Colonoscopy

Risk Categories

Time for the First Screening

Quality Assessment Parameters

Follow-up Surveillance and Repeat Intervals

Contraindications to Colonoscopy

Effectiveness

Complications

Hemorrhage and Perforation

Mortality

Abdominal Pain or Discomfort

Postpolypectomy Syndrome

Gas Explosion

Management of Anticoagulants and Platelet Inhibitors

Colonoscopy During Pregnancy

IBD—Screening and follow-up Pouchoscopies

Colorectal Screening for Elderly

Pearls and Pitfalls

References

11: Difficult Colonoscopy: Tricks and New Techniques for Getting to the Cecum

Key Points

Introduction

Patient Factors

Colonoscopist Factors

Water Immersion

Overtubes and Other Devices

Advanced Technologies and Novel Concepts

Summary

Pearls and Pitfalls

References

12: How to Recognize, Characterize, and Manage Premalignant and Malignant Colorectal Polyps

Key Points

Introduction

Molecular Pathways of Colorectal Neoplasia

Chromosomal Instability

Microsatellite Instability

CpG Island Methylation Phenotype

Endoscopic Features of Colorectal Polyps

The Paris Classification

Chromoscopy and Pit Patterns

Equipment-Based Image-Enhanced Endoscopy

The WASP Classification

Treatment Strategies for Colorectal Polyps

Indications for Endoscopic Resection

Real-Time Histological Diagnosis of Colorectal Polyps

Treatment Strategy of Submucosal CRCs

Treatment Strategy for Laterally Spreading Tumors (LSTs)

Endoscopic Resection Methods

Cold Biopsy

Cold Snare Polypectomy

Injection-Assisted Snare Polypectomy (Endoscopic Mucosal Resection, EMR)

EPMR

Endoscopic Submucosal Dissection (ESD)

Postpolypectomy Surveillance

Conclusion

Pearls and Pitfalls

References

13: Detection: (CQI) Quality Measures and Tools for Improvement

Key Points

Introduction

Continuous Quality Improvement

Quality Metrics in Colonoscopy

Preprocedure

General Evaluation

Appropriateness of Procedure

Intraprocedural

Cecal Intubation Rate

Withdrawal Time

Adenoma Detection Rate

Resection of Polyps

Adequacy of Bowel Preparation

Documentation

Postprocedure

Perforation

Bleeding

Screening and Surveillance Intervals

Strategies for Improvement

Training and Credentialing

Reporting and Payment Policy

Pearls and Pitfalls

References

14: Advanced Endoscopic Imaging: Polyps and Dysplasia Detection

Key Points

Introduction

Real-Time Optical Prediction of Polyp Histology

Chromocolonoscopy

Dye-Assisted Chromocolonoscopy

Digital Chromocolonoscopy

Improvement in Visualization

Cap-Assisted Colonoscopy

EndoRing

Endocuff

New Colonoscopy Technology

Third Eye Retroscope

Fuse® Full Spectrum Endoscopy Platform

Balloon Colonoscopy

Extra-Wide-Angle-View Colonoscope

Other Modalities

Summary

Pearls

Pitfalls

References

15: Endoscopic Mucosal Resection (EMR)

Key Points

Introduction

Indications for EMR

EMR Techniques

Injection-Assisted EMR

Cap-Assisted EMR

Ligation-Assisted EMR

Underwater EMR

Mucosal Lifting Agents

Clinical Outcomes of EMR

Complications and Management of Complications

Hemorrhage

Perforation

Postpolypectomy Syndrome

Comparison with ESD

Pearls and Pitfalls

Conclusion

References

16: Endoscopic Mucosal Dissection

Key Points

Introduction

Indications

How and What to Inject

Cautery Principles

Dual Knife

Hook Knife

Coagrasper

Snare Selection

Technique and Results

Complications

Bleeding

Perforation

Postprocedural Pain

Results for Early Colorectal Cancers

Conclusion

Pearls and Pitfalls

References

17: Applications of Intraoperative Endoscopy

Key Points

Introduction

Equipment and Setup

Intraoperative Endoscopic Localization

Completion Colonoscopy During Colon Resection

Intraoperative Assessment of Left-Sided Anastomoses

Management of Postoperative Anastomotic Leak

Anastomotic Bleeding

Pearls and Pitfalls

Conclusions

References

18: Combined Endoscopic and Laparoscopic Surgery (CELS)

Key Points

Introduction

Indications

Preoperative Planning

Procedure

Setup

Procedure Steps (Videos 18.1 and 18.2)

Endoscopy

Port Placement

Mobilization

Polypectomy

Colonoscopic-Assisted Laparoscopic Wall Excision

Full-Thickness CELS Technique

Leak Test

Polyp Retrieval

Postoperative Care

Complications

Outcomes

Pearls and Pitfalls

Conclusion

References

19: Endoluminal Colorectal Stenting

Key Points

Introduction

Stenting Malignant Colonic Strictures

Stenting with Palliative Intent

Stenting as “Bridge-to-Surgery”

Stenting of Extrinsic Colonic Obstruction

Stenting of Benign Colonic Strictures, Fistulas, and Anastomotic Complications

Stent Types

Metal Stents

Biodegradable Stents

Drug-Eluting Stents

Preparation and Technical Steps for Stent Deployment Patient Preparation

Description of the Procedure

Endoscopic Stent Placement Without Fluoroscopy

TTS Stent Placement

OTW Stent Placement

Fluoroscopic Stent Placement Without Endoscopy

Endoscopic-Fluoroscopic Stent Placement

Procedure-Related Complications

Early Complications

Late Complications

Post-stenting Care and Surveillance

Conclusions

References

20: How to Avoid Complications/Treatment of Endoscopic Complications

Key Points

How to Avoid Complications

How to Avoid Bleeding

How to Avoid Postpolypectomy Syndrome

How to Avoid Perforation

Treatment: Bleeding

Postpolypectomy Syndrome

Treatment: Perforation

Management Based on Diagnostic or Therapeutic Colonoscopy

Criteria for Conservative Management Versus Operation

Operative Options

Pearls and Pitfalls

References

21: Alternative Colorectal Imaging

Key Points

Introduction

Traditional Colonoscopy

Virtual Colonoscopy

Barium Enema

Magnetic Resonance Colonography

Capsule Endoscopy

Colon Capsule Endoscopy

Conclusion

References

22: Current Endoluminal Approaches: Transanal Endoscopic Microsurgery, Transanal Minimally Invasive

Key Points

The Evolution of Transanal Endoscopic Surgery and Transanal Total Mesorectal Excision

TEM and TEO

TAMIS

Transanal TME

TES: Indications, Contraindications, and Patient Selection

Rectal Adenoma

TES Versus TAE and EMR

Complex Adenomas

T1 Rectal Cancer

T2 and More Advanced Rectal Cancer

Other Indications

Patient Selection for TES

taTME: Indications, Contraindications, and Patient Selection

Benign Conditions

Rectal Cancer

Emerging Applications of taTME

Preoperative Staging, Assessment, and Preparation

Preoperative Assessment and Staging

Preoperative Preparation for TES

Preoperative Preparation for taTME

Technical Considerations

Procedural Steps for TES

Procedural Steps for taTME

Alternative taTME Techniques

Specimen Extraction

Closure of Rectal Defect

Postoperative Care and Surveillance

TES Complications

Perioperative Morbidity and Mortality

Peritoneal Entry

Functional Outcomes

Complications of taTME

Pearls and Pitfalls

Management of Peritoneal Entry During TES

taTME Dissection for Very Low Rectal Tumors in a Male Patient

taTME Operative Setup

Conclusion

References

23: Future Endoscopic Tools and Platforms for Endoluminal Surgery

Key Points

Introduction

Improvement of Endoscopic Insufflation

Need for Stable Endoscopic Exposure

Space-Pressure-Controlled Endoscopy

Preclinical Evaluation of Space

Implication

Improvement of Endoscopic Smoke Evaluation

Potential Hazards of Smoke in the GI Lumen

Automatic Smoke Evacuation System

Preclinical Evaluation of Evacuation System

Implication

Improvement of Endoscopic Working Space

Need for Stable Endoscopic Working Space

The ESP System

Preclinical Evaluation of ESP

Implications: ESP and SPACE

Other Future Improvements

Continuously Rotating Forceps

Suction/Irrigation Device

Countertraction Overture

Suturing Device

Flexible Robot

Pearls and Pitfalls

Conclusions

References

Index

 

 

 

An aparitie	12-Apr-17
Autor	Sang W. Lee , Howard M. Ross , David E. Rivadeneira , Scott R. Steele
Dimensiuni	21.54 x 2.06 x 28.83 cm
Editura	Springer
Format	Hardcover
ISBN	9783319483689
Limba	Engleza
Nr pag	265