Management of Large Sessile Polyps: EPMR vs. ESD
Fig. 3.1 Classification of LSTs The size and type of LSTs are good predictors of invasive cancer, and the proportion of submucosal carcinoma increases with increasing size of flat depressed…
GASTROENTEROLOGY
Preparation for Therapeutic Colonoscopy
Current medication Antiplatelet agent: aspirin, NSAIDs, dipyridamole, thienopyridines (clopidogrel and ticlopidine), GP II/IIIa inhibitors (tirofiban, abciximab, eptifibatide) Anticoagulant: warfarin, UFH, LMWH Medication affecting renal function: ACE inhibitor, angiotensin receptor blocker,…
Management of Colonic Obstruction
Definite Clinical signs of peritonitis Clinical and radiological signs of perforation or colonic suffering Associated small intestine obstruction Relative Time required to obtain endoscopic expertise Peritoneal carcinomatosis Patients undergoing anti-angiogenic…
Approaches to Splenic Flexure Mobilization
Fig. 9.1 Deconstructing the splenic flexure requires knowledge of the mesocolic vasculature as well as the critical retroperitoneal structures including the left renal vein (large arrow). The small arrow shows…
Total Mesorectal Excision
Fig. 10.1 Applying transabdominal sutures for retraction of the sigmoid colon Introduction In 1982, RJ Heald published and advocated the technique of total mesorectal excision (TME) for the surgical treatment…
SILS +1 Low Anterior Resection Versus Straight SILS
Fig. 16.1 Intraoperative view of the Ligament of Trietz, Inferior Mesenteric Vein, and Left Colic Artery for the splenic dissection portion of the operation 3. Incise the peritoneum deep to…
Technical Considerations, Available Platforms, and Ergonomics
Fig. 5.1 Olympus EndoEYE® Flex 3D Scope (Available online at http://medical.olympusamerica.com/products/laparoscopes/endoeye-flex-3d) Fig. 5.2 Example of laparoscopic camera with right-angle adaptor (From Stryker. Available online at: http://www.stryker.com/en-us/GSDAMRetirement/index.htmstellent/groups/public/documents/web_content/126633.pdf) Curved laparoscopic instruments were…
SILS Right Hemicolectomy
Fig. 12.1 Open a peritoneal window above and below the Ileocolic pedicle Fig. 12.2 Divide the Ileocolic artery 4. Open window below the pedicle (position is right side elevated, reverse…
Transanal Minimally Invasive Surgery for Local Excision
Fig. 20.1 The transanal placement of a TAMIS port is shown; this platform provides three 10 mm cannulas and insufflation is established using standard laparoscopic insufflators, or a vave-less trocar…
Dissection Approaches
Fig. 6.1 ‘Glove-port’ access device formed by use of conventional wound retractor, size 6 glove with three fingertips cut off and standard laparoscopic ports secured with non-absorbable suture ties Position,…
