| Theme |
Safety Procedures in Endoscopic Mucosectomy |
| Title |
Endoscopic Aspiration Mucosectomy |
| Author |
Ayao Torii |
Abdominal Center, Kyoto Katsura Hospital |
| [ Summary ] |
Devices,methods and safety of endoscopically aspirated mucosectomy were described. The method is as follows. First an ordinary videoendoscope with a double overtube is introduced into the stomach and the overtube introduced into the esophagus along the endoscope. The endoscope with the inner tube is pulled out and the endoscope introduced again through the outer tube. After marking around the lesion and submucosal injection, separation of the lesion from the muscularis propria is confirmed endosonographically using the miniature probe. Then the endoscope equipped with a hood attached to the snare-introducer is introduced. The lesion is suctioned into the hood and snared. Finally the lesion is removed by electocautery. Two major complications of endoscopic aspiration mucosectomy are bleeding and perforation. Bleeding at time of resection can be arrested by endoscopic clipping and that occuring after the procedure can be prevented by administration of a large dose of mucosa-protective agents. Perforation can be avoided by confirmation of appropriate submucosal injection using the ultrasonic probe. |