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Double transanal laparoscopic resection of large anal canal and low rectum polyps
Background: Rectal polyps, and especially small and medium-sized lesions are removed via conventional endoscopy. Large rectal polyps can be approached using endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). In more recent years, laparoscopic surgery underwent an evolution and a new application for endoluminal resection called transanal minimally invasive surgery (TAMIS) was introduced. The authors report the case of a 79-year-old man presenting with two large polyps of the anal canal (uTisN0) and low rectum (uTis vs T1N0), which were removed through TAMIS.
Video: The patient was placed in a prone, jackknife position with legs apart. The reusable transanal D-Port was introduced into the anus. Exploration of the cavity showed the presence of a large polyp involving the entire length of the anal canal and part of the lower third of the rectum and a second large polyp located 1cm above in the lower third of the rectum. The anal canal polyp was removed with the preservation of the muscular layer. The lower third rectal polyp was removed by resecting the full-thickness of the rectal wall. During the entire procedure, the surgeon worked under satisfactory ergonomics. The polyps were removed through the D-Port. The mucosal and submucosal flaps for anal canal resection, as well as the entire rectal wall opening for low rectal resection, were closed by means of two converging absorbable sutures.
Results: Operative time was 78 minutes for the anal canal polyp and 53 minutes for the low rectum polyp. Perioperative bleeding was 10cc. The postoperative course was uneventful, and the patient was discharged after 1 day. The pathological report for both polyps showed a tubulovillous adenoma with high-grade dysplasia and free margins (stage: pTis, 8 UICC edition).
Conclusions: TAMIS for double and large polyps located in the anal canal and low rectum offers advantages, such as excellent field exposure, safe en bloc polypectomy, and final endoluminal defect closure.
G Dapri
Surgical intervention
2 years ago
1443 views
233 likes
0 comments
07:49
Double transanal laparoscopic resection of large anal canal and low rectum polyps
Background: Rectal polyps, and especially small and medium-sized lesions are removed via conventional endoscopy. Large rectal polyps can be approached using endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). In more recent years, laparoscopic surgery underwent an evolution and a new application for endoluminal resection called transanal minimally invasive surgery (TAMIS) was introduced. The authors report the case of a 79-year-old man presenting with two large polyps of the anal canal (uTisN0) and low rectum (uTis vs T1N0), which were removed through TAMIS.
Video: The patient was placed in a prone, jackknife position with legs apart. The reusable transanal D-Port was introduced into the anus. Exploration of the cavity showed the presence of a large polyp involving the entire length of the anal canal and part of the lower third of the rectum and a second large polyp located 1cm above in the lower third of the rectum. The anal canal polyp was removed with the preservation of the muscular layer. The lower third rectal polyp was removed by resecting the full-thickness of the rectal wall. During the entire procedure, the surgeon worked under satisfactory ergonomics. The polyps were removed through the D-Port. The mucosal and submucosal flaps for anal canal resection, as well as the entire rectal wall opening for low rectal resection, were closed by means of two converging absorbable sutures.
Results: Operative time was 78 minutes for the anal canal polyp and 53 minutes for the low rectum polyp. Perioperative bleeding was 10cc. The postoperative course was uneventful, and the patient was discharged after 1 day. The pathological report for both polyps showed a tubulovillous adenoma with high-grade dysplasia and free margins (stage: pTis, 8 UICC edition).
Conclusions: TAMIS for double and large polyps located in the anal canal and low rectum offers advantages, such as excellent field exposure, safe en bloc polypectomy, and final endoluminal defect closure.
Endoscopic mucosal resection (EMR) of multiple hyperplastic polyps of the stomach
A 69 year-old man with a history of hypertension, type 2 diabetes, and renal insufficiency underwent a gastroscopy for chronic anemia. During this procedure, a 3cm hyperplastic gastric polyp was discovered. The patient was scheduled for endoscopic submucosal dissection (ESD). The procedure started with a gastroscopy, which showed a normal duodenum and many gastric hyperplastic polyps. The largest one was a pedunculated polyp of about 3cm in size at the level of the greater curvature. The operator opted for endoscopic mucosal resection (EMR) of the multiple polyps. After submucosal injection, polyps were resected using a snare (ENDO CUT® Q mode). All resected polyps were retrieved with a Roth Net® for histological evaluation.
A Lemmers, M Pizzicannella, F Habersetzer
Surgical intervention
1 year ago
413 views
1 like
0 comments
08:46
Endoscopic mucosal resection (EMR) of multiple hyperplastic polyps of the stomach
A 69 year-old man with a history of hypertension, type 2 diabetes, and renal insufficiency underwent a gastroscopy for chronic anemia. During this procedure, a 3cm hyperplastic gastric polyp was discovered. The patient was scheduled for endoscopic submucosal dissection (ESD). The procedure started with a gastroscopy, which showed a normal duodenum and many gastric hyperplastic polyps. The largest one was a pedunculated polyp of about 3cm in size at the level of the greater curvature. The operator opted for endoscopic mucosal resection (EMR) of the multiple polyps. After submucosal injection, polyps were resected using a snare (ENDO CUT® Q mode). All resected polyps were retrieved with a Roth Net® for histological evaluation.
Endoscopic full-thickness colonic resection for malignant polyp excision
This is the case of an 83-year-old woman who presented with per rectal bleeding. She had flexible sigmoidoscopy, which showed a 1.5 to 2cm flat polyp with central depression and non-lifting sign. CT-scan of the chest, abdomen, and pelvis was performed and showed no metastasis. The case was discussed with the multidisciplinary team and decision was made to perform an endoscopic full-thickness colonic resection. The case was performed using the colonic FTRD® set (OVESCO™). The procedure was completed successfully and the patient was discharged on postoperative day 1. During the postoperative follow-up, the resection margin was clear. This is the first case performed in the North-East of England to our knowledge. Since this case, we have performed another case.
Y Aawsaj, K Khan, M Hayat
Surgical intervention
1 year ago
856 views
2 likes
1 comment
05:30
Endoscopic full-thickness colonic resection for malignant polyp excision
This is the case of an 83-year-old woman who presented with per rectal bleeding. She had flexible sigmoidoscopy, which showed a 1.5 to 2cm flat polyp with central depression and non-lifting sign. CT-scan of the chest, abdomen, and pelvis was performed and showed no metastasis. The case was discussed with the multidisciplinary team and decision was made to perform an endoscopic full-thickness colonic resection. The case was performed using the colonic FTRD® set (OVESCO™). The procedure was completed successfully and the patient was discharged on postoperative day 1. During the postoperative follow-up, the resection margin was clear. This is the first case performed in the North-East of England to our knowledge. Since this case, we have performed another case.
Transanal minimally invasive full-thickness middle rectum polyp resection with the patient in a prone position
Background: Nowadays, rectal preservation has gained popularity when it comes to the management of degenerated rectal polyps or early rectal cancer (1, 2). Tis/T1 rectal lesions can be safely treated without chemoradiation (3). Treatment via transanal minimally invasive surgery (TAMIS) offers more advantages than endoscopic submucosal dissection (ESD) (4). The authors report the case of a 60-year-old woman who underwent a TAMIS procedure for a large polyp located anteriorly in the middle rectum, which was 7cm away from the pectineal line and staged as uTisN0M0 preoperatively.
Video: The patient was placed in a prone position with a split-leg kneeling position. A reusable transanal D-Port (Karl Storz Endoskope, Tuttlingen, Germany) was introduced into the anus together with DAPRI monocurved instruments (Figure 1). The polyp was put in evidence (Figure 2) and resection margins were defined circumferentially using the monocurved coagulating hook. A full-thickness resection was performed with a complete removal of the rectal serosa and exposure of the peritoneal cavity, due to the anatomical polyp positioning (Figure 3). The rectal opening was subsequently closed using two converging full-thickness running sutures using 3/0 V-loc™ sutures (Figure 4a). The two sutures were started laterally and joined together medially (Figure 4b).
Results: Total operative time was 60 minutes whereas suturing time was 35 minutes. There was no perioperative bleeding. The postoperative course was uneventful, and the patient was discharged after 2 days. The pathological report showed a tubular adenoma with high-grade dysplasia and clear margins.
Conclusions: In the presence of degenerated rectal polyps, full-thickness TAMIS is oncologically safe and feasible. The final rectal flap can be safely closed by means of laparoscopic endoluminal sutures.
G Dapri, L Qin Yi, A Wong, P Tan Enjiu, S Hsien Lin, D Lee, T Kok Yang, S Mantoo
Surgical intervention
2 years ago
1166 views
201 likes
0 comments
05:53
Transanal minimally invasive full-thickness middle rectum polyp resection with the patient in a prone position
Background: Nowadays, rectal preservation has gained popularity when it comes to the management of degenerated rectal polyps or early rectal cancer (1, 2). Tis/T1 rectal lesions can be safely treated without chemoradiation (3). Treatment via transanal minimally invasive surgery (TAMIS) offers more advantages than endoscopic submucosal dissection (ESD) (4). The authors report the case of a 60-year-old woman who underwent a TAMIS procedure for a large polyp located anteriorly in the middle rectum, which was 7cm away from the pectineal line and staged as uTisN0M0 preoperatively.
Video: The patient was placed in a prone position with a split-leg kneeling position. A reusable transanal D-Port (Karl Storz Endoskope, Tuttlingen, Germany) was introduced into the anus together with DAPRI monocurved instruments (Figure 1). The polyp was put in evidence (Figure 2) and resection margins were defined circumferentially using the monocurved coagulating hook. A full-thickness resection was performed with a complete removal of the rectal serosa and exposure of the peritoneal cavity, due to the anatomical polyp positioning (Figure 3). The rectal opening was subsequently closed using two converging full-thickness running sutures using 3/0 V-loc™ sutures (Figure 4a). The two sutures were started laterally and joined together medially (Figure 4b).
Results: Total operative time was 60 minutes whereas suturing time was 35 minutes. There was no perioperative bleeding. The postoperative course was uneventful, and the patient was discharged after 2 days. The pathological report showed a tubular adenoma with high-grade dysplasia and clear margins.
Conclusions: In the presence of degenerated rectal polyps, full-thickness TAMIS is oncologically safe and feasible. The final rectal flap can be safely closed by means of laparoscopic endoluminal sutures.
3D laparoscopic left colectomy with intraoperative colonoscopy: a live educational procedure
In this live educational procedure, Dr. Armando Melani presents the case of a 70-year-old female patient with a previous history of inferior right lobectomy secondary to T2 carcinoma. In 2018, during postoperative surveillance, PET-scan showed a left colon fixation. Colonoscopy revealed a polypoid lesion located 40cm away from the anal verge. Biopsy showed severe dysplasia. Endoscopic clips were placed for marking purposes. Three additional adenomatous polyps in the right, transverse, and left colon were found and removed. Preoperative abdominal X-ray showed the presence of clips at the level of the left pelvic bone. Since colonoscopy was performed more than two weeks before surgery, intraoperative colonoscopy was used to ensure tumor location.

During the video, surgical pitfalls were highlighted, and the author showed the importance of preoperative tumor tattooing, demonstrated anatomical landmarks, and the starting point of mesenteric dissection for left colectomy at the superior mesenteric vein (IMV). Recommendations for inferior mesenteric artery (IMA) ligation, hypogastric nerve preservation, splenic flexure mobilization, stapling recommendations during colon transection, colorectal anastomosis, and means to prevent postoperative complications were provided. The value of leak test, endoscopic anastomosis evaluation, and the use of indocyanine green (ICG) were also emphasized.
A Melani, A D'Urso, R Rodriguez Luna, D Mutter, J Marescaux
Surgical intervention
2 months ago
1290 views
21 likes
0 comments
17:09
3D laparoscopic left colectomy with intraoperative colonoscopy: a live educational procedure
In this live educational procedure, Dr. Armando Melani presents the case of a 70-year-old female patient with a previous history of inferior right lobectomy secondary to T2 carcinoma. In 2018, during postoperative surveillance, PET-scan showed a left colon fixation. Colonoscopy revealed a polypoid lesion located 40cm away from the anal verge. Biopsy showed severe dysplasia. Endoscopic clips were placed for marking purposes. Three additional adenomatous polyps in the right, transverse, and left colon were found and removed. Preoperative abdominal X-ray showed the presence of clips at the level of the left pelvic bone. Since colonoscopy was performed more than two weeks before surgery, intraoperative colonoscopy was used to ensure tumor location.

During the video, surgical pitfalls were highlighted, and the author showed the importance of preoperative tumor tattooing, demonstrated anatomical landmarks, and the starting point of mesenteric dissection for left colectomy at the superior mesenteric vein (IMV). Recommendations for inferior mesenteric artery (IMA) ligation, hypogastric nerve preservation, splenic flexure mobilization, stapling recommendations during colon transection, colorectal anastomosis, and means to prevent postoperative complications were provided. The value of leak test, endoscopic anastomosis evaluation, and the use of indocyanine green (ICG) were also emphasized.
Endoscopic Submucosal Dissection (ESD) of the rectum for a large rectal polypoid lesion: a live educational procedure
Endoscopic Submucosal Dissection (ESD) is an endoscopic technique which allows ‘en bloc’ resection of early stage tumors and polyps in the gastrointestinal tract. In this case, Professor Yahagi presents the case of a 67-year-old male patient with an incidental finding of a large rectal polyp during an MRI study. Colonoscopy revealed a 5cm laterally spreading tumor granular type (LST-G) of the rectum, extending to one fourth of the rectal circumference. The ESD was performed with a dual channel gastroscope in retrovision due to the proximity of the LST-G to the anal verge. Glycerol and indigo carmine were injected into the submucosal plane to lift the target lesion. The mucosal incision followed by submucosal dissection was performed with a 1.5mm DualKnife™ (Olympus) using a swift coag electrosurgical setting. Hemostasis of large vessels was performed switching to the forced coag effect. The vascular submucosal network has been carefully assessed. All critical steps are evaluated during the procedure.
N Yahagi, R Rodriguez Luna, M Pizzicannella
Surgical intervention
4 months ago
870 views
12 likes
3 comments
43:23
Endoscopic Submucosal Dissection (ESD) of the rectum for a large rectal polypoid lesion: a live educational procedure
Endoscopic Submucosal Dissection (ESD) is an endoscopic technique which allows ‘en bloc’ resection of early stage tumors and polyps in the gastrointestinal tract. In this case, Professor Yahagi presents the case of a 67-year-old male patient with an incidental finding of a large rectal polyp during an MRI study. Colonoscopy revealed a 5cm laterally spreading tumor granular type (LST-G) of the rectum, extending to one fourth of the rectal circumference. The ESD was performed with a dual channel gastroscope in retrovision due to the proximity of the LST-G to the anal verge. Glycerol and indigo carmine were injected into the submucosal plane to lift the target lesion. The mucosal incision followed by submucosal dissection was performed with a 1.5mm DualKnife™ (Olympus) using a swift coag electrosurgical setting. Hemostasis of large vessels was performed switching to the forced coag effect. The vascular submucosal network has been carefully assessed. All critical steps are evaluated during the procedure.
Laparoscopic partial TME for sessile polyp with intraoperative endoscopic control
Total mesorectal excision (TME) was described 20 years ago and is now recognized as the therapeutic gold standard for middle and lower third rectal cancers.
This is the case of a 70-year-old man with a BMI of 24 presenting with multiple polyps of the sigmoid colon larger than 3cm at 10 to 30cm from the anal verge. He has no past surgical history and colonoscopy revealed 3 sessile polyps at 15, 20, and 30cm from the anal verge as well as a flat polyp at 10cm from the anal verge. The histological examination concluded in one adenomatous, one adenovillous with high-grade dysplasia and one hyperplastic lesion. A laparoscopic partial TME with intraoperative endoscopic control is performed.
M Li
Surgical intervention
10 years ago
1925 views
8 likes
0 comments
25:16
Laparoscopic partial TME for sessile polyp with intraoperative endoscopic control
Total mesorectal excision (TME) was described 20 years ago and is now recognized as the therapeutic gold standard for middle and lower third rectal cancers.
This is the case of a 70-year-old man with a BMI of 24 presenting with multiple polyps of the sigmoid colon larger than 3cm at 10 to 30cm from the anal verge. He has no past surgical history and colonoscopy revealed 3 sessile polyps at 15, 20, and 30cm from the anal verge as well as a flat polyp at 10cm from the anal verge. The histological examination concluded in one adenomatous, one adenovillous with high-grade dysplasia and one hyperplastic lesion. A laparoscopic partial TME with intraoperative endoscopic control is performed.
Laparoscopic appendectomy for recurrent appendicitis after medical treatment
Appendectomy is the only curative treatment of appendicitis. However, the management of patients with an appendiceal mass or abscess can be temporarily managed medically with intravenous antibiotic therapy and/or percutaneous drainage. And yet, there are many controversies over the non-operative management of acute appendicitis. In 2015, Fair et al. used data from the American College of Surgeons National Surgical Quality Improvement Project to evaluate 30-day morbidity and mortality of intervention (laparoscopic and open appendectomy) at different time periods. A delay of operative intervention longer than 48 hours was associated with a doubling of complication rates. Elective appendectomy can be performed after 6 to 8 weeks later, which proves successful in the vast majority of patients.
This is the case of an 83-year-old man who presented with an acute appendicitis treated medically in another hospital. The patient had a past medical history of arterial hypertension, cardiomyopathy, previous cerebral ischemia, and rectal polyp. A delayed appendectomy was planned. However, before the procedure, a total colonoscopy was performed because of the history of polyps. This elderly patient was hospitalized for colonoscopy. At admission, he presented with fever, right iliac fossa tenderness, and a biological inflammatory syndrome. A CT-scan was performed. It showed a recurrent acute appendicitis without mass, with a 2cm abscess on the tip of the appendix. An appendectomy was performed in this case.
A D'Urso, D Mutter, J Marescaux
Surgical intervention
2 years ago
7018 views
346 likes
1 comment
05:00
Laparoscopic appendectomy for recurrent appendicitis after medical treatment
Appendectomy is the only curative treatment of appendicitis. However, the management of patients with an appendiceal mass or abscess can be temporarily managed medically with intravenous antibiotic therapy and/or percutaneous drainage. And yet, there are many controversies over the non-operative management of acute appendicitis. In 2015, Fair et al. used data from the American College of Surgeons National Surgical Quality Improvement Project to evaluate 30-day morbidity and mortality of intervention (laparoscopic and open appendectomy) at different time periods. A delay of operative intervention longer than 48 hours was associated with a doubling of complication rates. Elective appendectomy can be performed after 6 to 8 weeks later, which proves successful in the vast majority of patients.
This is the case of an 83-year-old man who presented with an acute appendicitis treated medically in another hospital. The patient had a past medical history of arterial hypertension, cardiomyopathy, previous cerebral ischemia, and rectal polyp. A delayed appendectomy was planned. However, before the procedure, a total colonoscopy was performed because of the history of polyps. This elderly patient was hospitalized for colonoscopy. At admission, he presented with fever, right iliac fossa tenderness, and a biological inflammatory syndrome. A CT-scan was performed. It showed a recurrent acute appendicitis without mass, with a 2cm abscess on the tip of the appendix. An appendectomy was performed in this case.
LIVE INTERACTIVE SURGERY: Colonoscopy and resection of large pedunculated sigmoid colon polyp
An intestinal polyp is a mass of tissue, which arises from the bowel wall and protrudes into the lumen. Polyps may be sessile or pedunculated. The incidence of polyps ranges from 7 to 50%. Polyps are most commonly found in the rectum and sigmoid colon and decrease in frequency towards the caecum.
Symptoms and signs:
Polyps are usually asymptomatic. The most frequent complaint is rectal bleeding, which is usually occult. Abdominal pain and obstruction occur with large polyps. The main concern with polyps is the risk of malignant transformation.
Complications of polypectomy: Common complications following polypectomy are bleeding and infection. The risk of bleeding ranges from 0.2 to 1.2%. When patients are on blood thinners, the risk of bleeding increases to 6.8%.
Advantages and disadvantages of use of prophylactic clips:
Clips can be applied during the procedure itself. They are easy to deploy. No scarring can be observed.
Disadvantages:
They are expensive, and present a risk of perforation and further bleeding.
R Dumas, S Leblanc
Surgical intervention
4 years ago
1163 views
39 likes
0 comments
11:52
LIVE INTERACTIVE SURGERY: Colonoscopy and resection of large pedunculated sigmoid colon polyp
An intestinal polyp is a mass of tissue, which arises from the bowel wall and protrudes into the lumen. Polyps may be sessile or pedunculated. The incidence of polyps ranges from 7 to 50%. Polyps are most commonly found in the rectum and sigmoid colon and decrease in frequency towards the caecum.
Symptoms and signs:
Polyps are usually asymptomatic. The most frequent complaint is rectal bleeding, which is usually occult. Abdominal pain and obstruction occur with large polyps. The main concern with polyps is the risk of malignant transformation.
Complications of polypectomy: Common complications following polypectomy are bleeding and infection. The risk of bleeding ranges from 0.2 to 1.2%. When patients are on blood thinners, the risk of bleeding increases to 6.8%.
Advantages and disadvantages of use of prophylactic clips:
Clips can be applied during the procedure itself. They are easy to deploy. No scarring can be observed.
Disadvantages:
They are expensive, and present a risk of perforation and further bleeding.
LIVE INTERACTIVE SURGERY: Endoscopic Submucosal Dissection (ESD) for colonic polyp
Colorectal polyps are the most common type of polyps. Early resection before the polyp undergoes malignant transformation is key to long-term survival and to a favorable prognosis.
Endoscopic submucosal dissection (ESD) has been developed based on endoscopic mucosal resection (EMR) techniques. ESD can be used to resect lesions regardless of size, location, and fibrosis.

Indications for ESD:
- colorectal tumors when EMR is not feasible;
- tumors >20mm in size;
- lateral spreading tumors (non-granular) type;
- lateral spreading tumors (granular type) with a nodule;
- residual and recurrent tumors.

Technique:
- to accurately define the margins;
- to mark the borders;
- to perform a circumferential incision;
- to perform a submucosal dissection.

Complications:
- perforations – 2.4% in colonic ESD;
- bleeding – may be immediate or delayed, occurring after the procedure.
The overall rate of complications is 1.5%.

Endoscopic ultrasound (EUS):
The use of high-frequency EUS is useful to determine the depth of invasion of colorectal lesions. According to some studies, the efficacy of EUS is found to be superior to chromoendoscopy in determining the depth of the tumor.
N Fukami
Surgical intervention
4 years ago
820 views
34 likes
0 comments
32:29
LIVE INTERACTIVE SURGERY: Endoscopic Submucosal Dissection (ESD) for colonic polyp
Colorectal polyps are the most common type of polyps. Early resection before the polyp undergoes malignant transformation is key to long-term survival and to a favorable prognosis.
Endoscopic submucosal dissection (ESD) has been developed based on endoscopic mucosal resection (EMR) techniques. ESD can be used to resect lesions regardless of size, location, and fibrosis.

Indications for ESD:
- colorectal tumors when EMR is not feasible;
- tumors >20mm in size;
- lateral spreading tumors (non-granular) type;
- lateral spreading tumors (granular type) with a nodule;
- residual and recurrent tumors.

Technique:
- to accurately define the margins;
- to mark the borders;
- to perform a circumferential incision;
- to perform a submucosal dissection.

Complications:
- perforations – 2.4% in colonic ESD;
- bleeding – may be immediate or delayed, occurring after the procedure.
The overall rate of complications is 1.5%.

Endoscopic ultrasound (EUS):
The use of high-frequency EUS is useful to determine the depth of invasion of colorectal lesions. According to some studies, the efficacy of EUS is found to be superior to chromoendoscopy in determining the depth of the tumor.
LIVE INTERACTIVE SURGERY: Esophagogastroduodenoscopy (EGD), chromoendoscopy, and BARRX treatment of remaining Barrett's mucosa
Chromoendoscopy is a procedure where dyes are instilled in the gastrointestinal tract at the time of visualization with endoscopy. It enhances the characterization of the tissues. The most common applications are as follows:
- Identification of squamous cell carcinoma or dysplasia;
- Identification of Barrett’s esophagus;
- Detection of early gastric cancer;
- Characterization of colonic polyps;
- Screening.
BARRX™ is a radiofrequency ablation of the metaplastic esophageal mucosa. The concept is to resect the epithelium and the muscularis mucosa without damaging the submucosa. It reduces the risk of developing carcinoma.
E Coron, G Rahmi
Surgical intervention
4 years ago
449 views
20 likes
0 comments
09:12
LIVE INTERACTIVE SURGERY: Esophagogastroduodenoscopy (EGD), chromoendoscopy, and BARRX treatment of remaining Barrett's mucosa
Chromoendoscopy is a procedure where dyes are instilled in the gastrointestinal tract at the time of visualization with endoscopy. It enhances the characterization of the tissues. The most common applications are as follows:
- Identification of squamous cell carcinoma or dysplasia;
- Identification of Barrett’s esophagus;
- Detection of early gastric cancer;
- Characterization of colonic polyps;
- Screening.
BARRX™ is a radiofrequency ablation of the metaplastic esophageal mucosa. The concept is to resect the epithelium and the muscularis mucosa without damaging the submucosa. It reduces the risk of developing carcinoma.