By Toyooki Sonoda

This publication offers surgeons and gastroenterologists with cutting-edge suggestions when it comes to complex colonoscopy. Chapters introduce equipment of elimination polyps that weren't formerly amenable to colonoscopic snare polypectomy. complicated innovations reminiscent of closure of perforations and intestinal stenting are largely coated. The textual content keeps a robust emphasis on surgical/endoscopic strategy. wide dialogue on gear and ability acquisition can also be coated. As many readers won't ever have obvious those complicated tactics prior to, vast pictures and movies are supplied. The authors supply guidance, tips, and pitfalls that might aid the reader include those new options into their practice.

Advanced Colonoscopy: Polypectomy and past may be of serious price to any physician or gastroenterologist at present appearing colonoscopy and attracted to complex techniques.​

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Extra resources for Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy

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Endoscopic mucosal resection of colon polyps. Gastrointest Endosc Clin N Am. 2001;11(3):537–48. 8. Gilbert DA, DiMarino AJ, Jensen DM, Katon R, Kimmey MB, Laine LA, MacFadyen BV, Michaletz-Onody PA, Zuckerman G. Status evaluation: hot biopsy forceps. American Society for Gastrointestinal Endoscopy Technology Assessment Committee. Gastrointest Endosc. 1992;38(6):753–6. 9. Valentine JF. Double-channel endoscopic polypectomy technique for the removal of large pedunculated polyps. Gastrointest Endosc.

2013;56(5):660–6. 2 Difficult Polyps: Conventional Methods 29 12. Hurlstone DP, Cross SS, Drew K, Adam I, Shorthouse AJ, Brown S, Sanders DS, Lobo AJ. An evaluation of colorectal endoscopic mucosal resection using high-magnification chromoscopic colonoscopy: a prospective study of 1000 colonoscopies. Endoscopy. 2004;36(6):491–8. 13. Cruz RA, Ragupathi M, Pedraza R, Pickron TB, Le AT, Haas EM. Minimally invasive approaches for the management of “difficult” colonic polyps. Diagn Ther Endosc. 2011;2011: 682793.

Sessile polyps are usually straightforward to snare, but flat polyps are difficult because the snare tends to slip off. Depressed polyps are a real challenge for conventional techniques. 3. Location: Polyps sitting in a flexure, or around a turn in the sigmoid colon, are often difficult to access with endoscopic instruments. If the colon is mobile, the fold can slip away from the scope. If the colon contracts or spasms, the polyp may be lost to sight. Polyps on the backside of a haustral fold, or polyps that are draped over a fold, are difficult because parts of the lesion are invisible and hard to access.

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