Bite-on-bite technique for removal of a gastric subepithelial lipoma.
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ABSTRACT:
SUBMITTER: Ehrlich D
PROVIDER: S-EPMC6408735 | biostudies-literature | 2019 Mar
REPOSITORIES: biostudies-literature
Publications
Bite-on-bite technique for removal of a gastric subepithelial lipoma.
Ehrlich Dean D Mukewar Saurabh S Wang Hanlin H Muthusamy V Raman VR
VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20190204 3
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Project description: Not available
| S-EPMC5991856 | biostudies-literature
Project description:BACKGROUND : Endoscopic surveillance is recommended in patients with hereditary diffuse gastric cancer (HDGC) who refuse or want to delay surgery. Because early signet-ring cell carcinoma (SRCC) can be inconspicuous, the current surveillance endoscopy protocol entails 30 random biopsies, which are time-consuming. This study aimed to compare single-bite and double-bite techniques in HDGC surveillance. METHODS : Between October 2017 and December 2018, consecutive patients referred for HDGC surveillance were prospectively randomized to the single- or double-bite arm. The primary outcome was the diagnostic yield for SRCC foci. Secondary outcomes were: procedural time for random biopsies; comfort score; biopsy size; and quality of specimens, the latter assessed by the presence of muscularis mucosa, crush artifact, and proportion usable for diagnostic assessment. RESULTS : 25 patients were randomized to the single-bite arm and 23 to the double-bite arm. SRCC foci were detected in three and four patients in the single- and double-bite arms, respectively (P = 0.70). The procedural time for the double-bite arm (12 minutes, interquartile range [IQR] 4) was significantly shorter than for the single-bite arm (15 minute, IQR 6; P = 0.01), but comfort scores were similar. The size of the biopsies in the double-bite arm was significantly smaller than in single-bite arm (2.5 mm vs. 3.0 mm; P < 0.001) but this did not affect the presence of muscularis mucosa (P = 0.73), artifact level (P = 0.11), and diagnostic utility (P = 0.051). CONCLUSION : For patients undergoing HDGC surveillance, the double-bite technique is significantly faster than the single-bite technique. The diagnostic yield for SRCC and the biopsy quality were similar across both groups.
| S-EPMC7116833 | biostudies-literature
Project description: Not available
| S-EPMC6003899 | biostudies-literature
Project description:An 85-year-old male referred to the Gastroenterology (GI) clinic with three-month history of failure to thrive and three-week history of nausea, vomiting, and melanotic stools. Ulcerative mass obstructing gastric outlet was found on endoscopy and on follow-up CT abdomen a homogeneous submucosal mass in the gastric antrum was identified. Radiological diagnosis of giant gastric lipoma was established and patient was evaluated for surgery and, however, was rendered unfit for surgery due to his comorbid conditions. Patient was taken for endoscopic resection of the mass. On endoscopy, only partial resection was achieved due to the size of the mass, but endoloops were deployed at the stalk at the end of the procedure in hope of limiting blood supply to the lesion. On six-week follow-up endoscopy, patient's mass had completely disappeared with limited scar tissue at the site.
| S-EPMC6393926 | biostudies-literature
Project description:BackgroundMinimally invasive surgery had been tailored to individual cases of gastric subepithelial tumors (SETs) after comparing the clinical outcomes of endoscopic resection (ER), laparoscopic resection (LR), and hybrid methods.AimTo study the use of Goldilocks principle to determine the best form of minimally invasive surgery for gastric SETs.MethodsIn this retrospective study, 194 patients of gastric SETs with high probability of surgical intervention were included. All patients underwent tumor resection in the operating theater between January 2013 and December 2021. The patients were divided into two groups, ER or LR, according to the tumor characteristics and the initial intent of intervention. Few patients in the ER group required further backup laparoscopic surgery after an incomplete ER. The patients who had converted open surgery were excluded. A logistic regression model was used to assess the associations between patient characteristics and the likelihood of a treatment strategy. The area under the curve was used to assess the discriminative ability of tumor size and Youden's index to determine the optimal cut-off tumor size.ResultsOne-hundred ninety-four patients (100 in the ER group and 94 in the LR group) underwent tumor resection in the operating theater. In the ER group, 27 patients required backup laparoscopic surgery after an incomplete ER. The patients in the ER group had small tumor sizes and shorter procedure durations while the patients in the LR group had large tumor sizes, exophytic growth, malignancy, and tumors that were more often located in the middle or lower third of the stomach. Both groups had similar durations of hospital stays and a similar rate of major postoperative complications. The patients in the ER group who underwent backup surgery required longer procedures (56.4 min) and prolonged stays (2 d) compared to the patients in the LR group without the increased rate of major postoperative complications. The optimal cut-off point for the tumor size for laparoscopic surgery was 2.15 cm.ConclusionMultidisciplinary teamwork leads to the adoption of different strategies to yield efficient clinical outcomes according to the tumor characteristics.
| S-EPMC10494604 | biostudies-literature
Project description:Video 1Endoscopic submucosal dissection of a giant esophageal lipoma.
| S-EPMC8431273 | biostudies-literature
Project description:PurposeTransurethral resection of bladder tumor (TURBT) can be a challenging procedure for an inexperienced surgeon. We suggest an easy technique for TURBT, which we have named the "grasp and bite" technique. We describe this technique and compare its effectiveness and safety with that of conventional TURBT.Materials and methodsMonopolar TURBT (24-Fr Karl Storz) was performed in 35 patients who had superficial bladder tumors. After defining the tumor margin, the tumor and surrounding mucosa were grasped by use of a loop electrode and resectoscope sheath. With tight grasping, linear moving resection was performed. The patients' demographic, intraoperative, and postoperative data were analyzed between the conventional and grasp and bite TURBT groups.ResultsOf 35 patients, 16 patients underwent conventional TURBT (group 1), and the other 19 patients underwent grasp and bite TURBT (group 2). Both groups were similar in age, tumor multiplicity, size, anesthesia method, and location. Grasp and bite TURBT could be performed as safely and effectively as conventional TURBT. There were no significant differences in irrigation duration, urethral catheterization, postoperative hemoglobin drop, or length of hospital stay. No significant side effects such as bladder perforation, severe obturator reflex, or persistent bleeding occurred. There were no significant pathological differences between specimens according to the type of resection technique.ConclusionsThe grasp and bite TURBT technique was feasible for superficial bladder tumors. It may be a good tool for inexperienced surgeons owing to its convenient and easy manner.
| S-EPMC4355434 | biostudies-literature
Project description:Video 1We depict (1) identification of a large lipoma in the sigmoid colon; (2) radial echo endoscopy confirming diagnosis; (3) removal with the loop-and-let-go technique; (4) ex vivo demonstration of the technique; and (5) an interval follow-up demonstrating healing of the lesion.
| S-EPMC10422078 | biostudies-literature
Project description:IntroductionPonseti casting method is the gold standard for the management of congenital talipes equinovarus in neonates, which consists of weekly manipulation and serial casting. Using oscillatory saw for cast removal is user-dependant and has been fraught with complications consisting of saw burns, thermal abrasions, anxiety, and fear of the saw (especially in children). The aim of this article is to describe our technique of cast removal using visual media format.TechniqueThis video describes an easy method of cast soakage with lukewarm water. Once the cast is soaked in water, the knob is identified, and the loosened outer layer of the cast is unwrapped in layers. Complete procedure can be done at home by parents. Since no equipment is utilized, the technique eliminates all complications associated with an oscillating saw.ConclusionCast soakage with lukewarm water followed by unwrapping is a simple and cost-effective method of Ponseti cast removal which can be done by parents at home improving the overall satisfaction of the family.
| S-EPMC8051574 | biostudies-literature
Project description:BACKGROUND/AIM:To report cases in which we achieved sufficient width of the keratinized gingiva using a coronally advanced flap in combination with a subepithelial connective tissue graft (SCTG) obtained by the 'CO2 laser de-epithelization technique' (CODE). PATIENTS AND METHODS:Eleven patients with 21 Miller Class I, II, and III gingival recessions had surgery. To prepare SCTG, free gingival grafts were harvested and de-epithelialized extra-orally. De-epithelialization was conducted by irradiation of CO2 laser. Postoperative examinations were performed at 12 months. RESULTS:At 12 months, statistically highly significant root coverage was achieved in all recessions. Complete root coverage was obtained in 7 of the 21 recessions. The treatment yielded mean root coverage of 41.0%, and was associated with a mean gain of keratinized gingiva of 2.9±0.3 mm. CONCLUSION:The use of CODE allows harvesting grafts of excellent quality and quantity and increases the keratinization of the overlying mucosal epithelium.
| S-EPMC7157886 | biostudies-literature