|
|
Jason R. Taylor, MD, University of Michigan B. Joseph Elmunzer, MD, University of Michigan Cyrus R. Piraka, MD, University of Michigan Richard S. Kwon, MD, University of Michigan
We present a case of a 44 y old woman with primary biliary and alcoholic cirrhosis who presented with RUQ pain and encephalopathy. Further evaluation revealed acute cholecystitis with VRE and Candida bacteremia. She was not a candidate for laparoscopic cholecystectomy or radiologic cholecystostomy tube due to her decompensated cirrhosis, with a M [...]
Stavros N. Stavropoulos, M.D., Winthrop University Hospital
Laparoscopic Heller myotomy is recommended as primary treatment of achalasia in patients at low surgical risk. Problems have been reported with surgical myotomy that include gastroesophageal reflux disease in up to 8% of patients even with fundoplication. These patients are at risk of developing Barrett's esophagus and esophageal carcinoma. [...]
Roos E. Pouw, MD, Academic Medical Center, University of Amsterdam, The Netherlands
The first case shows a 61-year old man with a flat-type adenoma in the bulbus, with low-grade dysplasia in biopsies. The lesion was removed using the multi-band mucosectomy technique. The first resection, however, resulted in an 8-mm large perforation. Here you see the flat type lesions in the bulbus and the luminal defect immediately after endosc [...]
Keith L. Obstein, MD, Brigham and Women’s Hospital Jayender Jagadeesan, PhD, Brigham and Women’s Hospital Vaibhav D. Patil, MD, Brigham and Women’s Hospital R. San Jose-Estepa, I.S. Spofford, Balazs Lengyel, MD, Brigham and Women’s Hospital Michele B. Ryan, MS, Kirby G. Vosburgh, PhD, Brigham and Women’s Hospital Christopher C. Thompson, M.D., Brigham and Women’s Hospital
Consider the benefits of looking inside the human body during an interventional procedure and seeing in real-time all anatomic structures in precise three-dimensional detail. This is what Image Guided Intervention technology provides its users. Image guided technologies allow for integration of imaging modalities and interventional procedures [...]
Marvin Ryou, MD, Brigham and Women’s Hospital Padraig J. Cantillon-Murphy, PhD, Brigham and Women’s Hospital Dan E. Azagury, MD, Brigham and Women’s Hospital Sohail N. Shaikh, MD, Brigham and Women’s Hospital Gabriel Ha, BS, Michele B. Ryan, MS, Jeffrey H. Lang, PhD, Massachusetts Institute of Technology Christopher C. Thompson, M.D., Brigham and Women’s Hospital
Background/ Case: Magnets have previously been shown to be useful in endoscopic foreign body removal, EMR, and also in a NOTES surgical/navigation system. Endoscopic Methods: Thre endoscopic applications are presented that feature the novel use of rare-earth magnets. (1) NOTES magnetic retraction using and external magnet interacting with [...]
Elena Dubcenco, MD, Johns Hopkins Medical Center
This experiment was aimed to demonstrate the technical feasibility of NOTES small bowel resection via a combined transgastric-transvaginal approach. The procedure was performed in a laboratory setting of the Johns Hopkins University School of Medicine. Acute porcine model was used. A pig was placed on the operating table in the supine positio [...]
David J. Desilets, MD, PhD,
Our procedure begins with a PEG-type transgastric abdominal access. A wire is placed percutaneously into the stomach, a balloon is passed over the wire into the abdominal cavity, and the balloon is inflated. The endoscope exits the stomach into the abdominal cavity by following the balloon as we push out over the guidewire. Once the Savary is in pl [...]
Field Willingham, MD, MPH, Massachusetts General Hospital
En Bloc Esophageal Mucosectomy, an experimental technique for the endolumenal management of Barrett's related dysplasia and neoplasia. High grade dysplasia is in indication for esophagectomy; however esophagectomy has a mortality rate up to 12 percent, and up to 56 percent of patients may develop serious post-operative complications. Multipl [...]
Daniel J. Scott, M.D., University of Texas Southwestern Medical Center Jeffrey A. Cadeddu, MD, University of Texas Southwestern Medical Center Mouza T. Goova, MD, University of Texas Southwestern Medical Center Shou Jiang Tang, MD, University of Texas Southwestern Medical Center Richard Bergs, MS, University of Texas Southwestern Medical Center Raul Fernandez, PhD, University of Texas Southwestern Medical Center
Natural Orifice Translumenal Endoscopic Surgery is an exciting and evolving field. Our multi-disciplinary research team has developed prototype instruments suitable for transvaginal cholecystectomy in an experimental porcine model. Our access port is 50 cm long and has 2 instrument insertion channels with conventional laparoscopic trocar seals and [...]
Marvin Ryou, MD, Brigham and Women’s Hospital Reina D. Pai, MD, Brigham and Women’s Hospital Derek G. Fong, MD, Brigham and Women’s Hospital David W. Rattner, M.D., Massachusetts General Hospital Christopher C. Thompson, M.D., Brigham and Women’s Hospital
As the line separating GI endoscopy and abdominal surgery begins to blur, old principles of tissue manipulation become particularly salient. Significant examples include adequate exposure, understanding tissue planes, triangulation of instruments, and robust traction and counter-traction. We propose novel techniques for exposure and dissection that [...]
|