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Rhinolaryngoscopy for the Allergist
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Jerald W Koepke, William K Dolen
The patient is reminded that he may talk to the examiner during the examination. With good anesthesia, the procedure is not painful although the patient may report pressure from the endoscope. The patient should be asked to communicate any discomfort to the examiner so that the endoscope may be withdrawn from that area.
Interventional radiology
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Fluoroscopically guided balloon dilation of esophageal strictures is simple and safe, and has replaced bougienage. Endoscopy can be regarded as an additional procedure, with certain advantages over a purely fluoroscopic technique, including the ability to inspect and biopsy the esophagus and to evaluate the stomach and proximal small intestine.
Chronic Idiopathic Constipation
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Structural causes of constipation are more likely to be found in someone with a short history of complaints or when there has been a recent change in bowel habits rather than in a patient with longstanding constipation. Certainly, endoscopic studies should not be performed repeatedly in patients with chronic stable complaints, because they are expensive and time-consuming and occasionally cause complications.
Donor kidney lithiasis and back-table endoscopy: a successful combination
Published in Acta Chirurgica Belgica, 2023
Michaël M. E. L. Henderickx, Joyce Baard, Pauline C. Wesselman van Helmond, Ilaria Jansen, Guido M. Kamphuis
After the donor nephrectomy, the back-table was prepared for a flexible ureterorenoscopy (Figure 1). In case this would not be successful, a pyelotomy was considered for stone extraction. First, two stitches with a nonabsorbable suture (Ethilon® nyon suture 3/0; Ethicon; Sommerville; New Jersey; USA) were placed in the distal part of the ureter to allow stabilization and introduction of a hybrid guidewire (straight tip Sensor guidewire 0.038′′ × 150 cm; Boston Scientific). The ureter was not spatulated. After positioning the guidewire, a flexible ureterorenoscope (URF-P6® 7.95French distal tip; Olympus; Hamburg; Germany) (URS) was advanced over the guidewire into the renal pelvis. Subsequently, all calyces were inspected. Fluoroscopic guidance was not used during this procedure. The stone was found in the lower pole of the kidney. However, it was still covered by a thin film of the urothelium. After opening the surrounding urothelium with a Holmium YAG laser (100 Watt; Lumenis Ltd.; Yokneam Illit; Israel) and single-use laser fiber (Flexiva TracTip®; Boston Scientific; Marlborough; Massachusetts; USA), all fragments were removed with a Nitinol tipless stone extractor (NCircle® 1.5French; 115 cm; Cook Medical; Bloomington; Indiana; USA) (Figure 1). After final inspection, no residual stones were observed. The total operation time for the back-table endoscopy was 36 min.
The clinical application progress and potential of drug-induced sleep endoscopy in obstructive sleep apnea
Published in Annals of Medicine, 2022
Alonço Viana, Débora Estevão, Chen Zhao
Recommended monitoring during DISE includes oxygen saturation (SaO2), electrocardiogram (ECG), and blood pressure (BP). A video-endoscopy system with a flexible nasoendoscope 4 mm in diameter or smaller can be used. Other suggested supplies and equipment include: (i) a standard infusion pump, preferably with target-controlled infusion (TCI). TCI is more effective and safer, allowing better adjustment of the infusion speed [16]; and (ii) a monitoring system for electroencephalogram (EEG)-derived indices - Bi-Spectral Index (BIS) or Cerebral State Index (CSI) [5]. BIS can assist in controlling the level of consciousness and the depth of sedation to mimic natural sleep, with recommended rates of 50–60 [17,18]. Cardiorespiratory polygraphy is suggested for identifying obstructive respiratory events due to hypopneas [19].
Angiography and transcatheter arterial embolization for non-variceal gastrointestinal bleeding
Published in Scandinavian Journal of Gastroenterology, 2020
Hai-Yang Lai, Ke-Tong Wu, Yang Liu, Zhao-Fei Zeng, Bo Zhang
Gastrointestinal bleeding can be caused by a variety of pathologies and they differ in onset, location, risk and clinical presentation. Emergency resuscitation should be preferred to any investigations for patients with active gastrointestinal bleeding who are unstable [1,27]. Upper endoscopy and colonoscopy are still the mainstay for the diagnosis and treatment of gastrointestinal bleeding. However, there are several limitations of endoscopy in a setting of acute gastrointestinal bleeding, including inadequate bowel preparation, the influence of large blood clots and fecal content, as well as risks associated with sedation and perforation. Therefore, the definite or potential source of bleeding can be obscured by these limitations, resulting in a high rate of non-diagnostic endoscopic examinations. In our study, 76 of the 158 patients underwent endoscopic examination before angiography, and bleeding was confirmed in 40 patients (52.6%). Among them, endoscopic hemostasis was performed but failed in 26 patients, and endoscopic hemostasis was difficult to perform in the other 14 patients due to vascular malformation, intestinal mass and intestinal diffuse bleeding. The remaining 82 patients did not undergo endoscopic examination before angiography, the causes of which included poor gastrointestinal preparation for massive bleeding, hemorrhagic shock, lack of cooperation with the endoscopic examination, and bleeding caused by gastrointestinal tumors.