| 特集名 | 大腸の治療内視鏡 -- 最近の進歩 | |
|---|---|---|
| 題名 | 内視鏡機器と治療 (1) ダブルバルーン内視鏡の大腸治療への応用 | |
| 発刊年月 | 2005年 12月 | |
| 著者 | 矢野 智則 | 自治医科大学内科学講座消化器内科学部門 |
| 著者 | 山本 博徳 | 自治医科大学内科学講座消化器内科学部門 |
| 著者 | 喜多 宏人 | 自治医科大学内科学講座消化器内科学部門 |
| 著者 | 砂田 圭二郎 | 自治医科大学内科学講座消化器内科学部門 |
| 著者 | 宮田 知彦 | 自治医科大学内科学講座消化器内科学部門 |
| 著者 | 岩本 美智子 | 自治医科大学内科学講座消化器内科学部門 |
| 【 要旨 】 | ダブルバルーン内視鏡は，バルーン付きオーバーチューブと内視鏡先端のバルーンを用いることで屈曲した腸管の伸展を抑制し，オーバーチューブ上に腸管を短縮して挿入するため，大腸内視鏡挿入困難例においても被検者に苦痛を与えることなく盲腸まで挿入することができる．オーバーチューブ先端のバルーンで腸管を把持することにより，安定した固定点を任意の位置に設定できるため，通常内視鏡では操作が不安定になる部位においても，高い精度の操作を安定して行うことができる．このことは大腸においてポリペクトミー，endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD) などの内視鏡的治療を安全に施行するための大きな助けとなると考えられる． | |
| Theme | Therapeutic Colonoscopy -- Recent Advances | |
|---|---|---|
| Title | Endoscopic Colon Treatment Using Double-Balloon Endoscopy | |
| Author | Tomonori Yano | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Hironori Yamamoto | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Hiroto Kita | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Keijiro Sunada | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Tomohiko Miyata | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Michiko Iwamoto | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| [ Summary ] | Double-balloon endoscopy uses 2 balloons, one attached to the tip of the endoscope and another at the distal end of an overtube. By using these balloons to grip the intestinal wall, the endoscope can be inserted further without forming redundant loops in the intestine. The main reason for difficulty with endoscope insertion is not the curvature of the intestine itself, but the extension of the bent intestine. We have therefore devised a technique to prevent intestinal extension by holding it with a balloon attached to the distal end of a soft overtube. As long as this overtube prevents intestinal extension, the distal end of the endoscope can be advanced by inserting it through the overtube, even if the intestine is curved to some extent. In many cases of unsuccessful colonoscopy, the endoscope cannot be straightened because the loop in the sigmoid colon or the curvature of the transverse colon cannot be overcome, due to adhesions or other reasons ; even in such cases, our method enables deeper insertion of the endoscope by holding the intestine with the minimum amount curvature. This technique provides a stabilized maneuver without paradoxical movement. Therefore, this is useful to perform endoscopic therapies such as polypectomies, endoscopic mucosal resection, and endoscopic submucosal dissection in a difficult portions of the colon. |
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