1. Polypectomy of LST by HQ290

    03:35

    from Nanumdr / Added

    100 Plays / / 0 Comments

    Polypectomy of LST by HQ290

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    • Adénome dégénéré du haut rectum traité par dissection sous muqueuse ESD

      05:52

      from Vincent Lépilliez / Added

      3 Plays / / 0 Comments

      Patient atteint d'une large LST non granulaire déprimée du haut rectum. Traitement par dissection sous muqueuse après un bilan complet comportant une échoendoscopie normale. On observe sur la vidéo la technique de résection qui est réalisé à l'aide d'un prototype de bistouri (NESTIS), qui permet l'injection d'eau à haute pression et la dissection par électrocoagulation avec le même instrument, ce qui évite les multiples échange d'instruments. La pièce histologique confirme l'adénocarcinome superficiel avec invasion de la première couche de la sous muqueuse sur 300 micromètres avec résection en zone saine.

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      • Toronto 2014 live: Underwater EMR of a large rectal adenoma

        10:00

        from Endovision / Added

        Live demonstration at the 27th International Course on on Therapeutic Endoscopy in Toronto, Canda, October 1-3 2014. Dr Binmoeller demonstrates the technique of underwater piecemeal EMR of a large rectal LST (granular type, Paris Is/IIa) Commentary provided by Dr John Morris (Scotland) . Panelists: Dr Horst Neuhaus (Germany), Dr Greg Haber (Canada).

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        • Underwater en bloc resection (UEBR) of a SSA in the transverse colon

          01:45

          from Endovision / Added

          2.5 cm nongranular sessile serrated adenoma (SSA) in the transverse colon along a fold. On the "air" view, the lesion is flattened and mimics a thickened fold. Surface irregularities suggestive of adenoma are only seen with closer inspection. Water immersion facilitates detection due to contraction and the magnification effect, and enables en bloc removal due to infolding of the mucosa. Diathermic marking of the perimeter is performed to ensure the entire lesion is removed. Surgical pathology confirmed SSA with disease-free margins.

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          • Underwater EMR (UEMR) of a flat NG-type LST along a fold

            01:11

            from Endovision / Added

            Underwater resection of a flat non-granular type IIa laterally spreading tumor along 3/4 of a fold Biopsies showed tubular adenoma. Underwater piecemeal EMR performed without submucosal injection. EMR was performed with a duckbill snare Resection was begun at the margin. The snare was opened and positioned to include normal mucosa at the margins identified by the diathermic dots. A ‘torque and crimp’ technique was used to maximize tissue capture: the opened snare was pushed flush against the bowel wall and torqued to engage a pleat of tissue. The snare was closed and pure cutting current applied to transect the captured tissue. Adjacent portions of the polyp were resected in a piecemeal fashion along the same resection plane, taking care not to leave any “bridges” or “islands” of intervening adenoma

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            • Underwater EMR (UEMR) of a SSA that failed a prior resection attempt

              01:08

              from Endovision / Added

              Underwater resection of a 2 cm Paris Iic + IIa laterally spreading tumor, non-granular type. A prior attempt at piecemeal snare resection failed. Underwater piecemeal (2 pieces) EMR performed without submucosal injection using a 15mm duckbill snare. Note heavy staining of the submucosa with India Ink after resection. The ink can cause significant scarring and therefore the tattoo should be placed on the opposite wall of the lesion.

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              • Underwater EMR of a flat non-granular type LST

                01:15

                from Endovision / Added

                Underwater resection of a very flat non-granular type IIa laterally spreading tumor along a fold Biopsies showed high-grade dysplasia. Underwater piecemeal EMR performed without submucosal injection using a 15mm duckbill snare.

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                • Underwater EMR (UEMR) in the upper rectum

                  02:22

                  from Endovision / Added

                  39 y/o male with chronic rectal bleeding over 1 year. Diagnosed with hemorrhoids and underwent hemorrhoidectomy. Bleeding persisted -> colonoscopy -> large 1s IIa granular-type villous growth along one-half of the circumference of the anterior wall of the upper rectum. Biopsies: villous adenoma with focal high grade dysplasia. Underwater piecemeal EMR performed without submucosal injection.

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                  • Underwater en bloc resection (UEBR) of a large cecal SSA

                    02:07

                    from Endovision / Added

                    81 y/o female with hemoccult positive stools found to have a large 2.5 cm growth in the cecum. Biopsies: sessile serrated adenoma. Underwater en bloc resection (UEBR) performed without submucosal injection.

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                    • Underwater en bloc resection (UEBR) of a giant TV-adenoma

                      01:57

                      from Endovision / Added

                      62 y/o male underwent screening colonoscopy and found to have a large multilobulated 1s 2a granular-type growth in the descending colon involving 3/4 of the circumference. Biopsies: tubular-villous adenoma.Underwater en bloc resection (UEBR) performed without submucosal injection

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