Development Of Endoscopy Research Articles

The application of the combination between artificial intelligence and endoscopy in gastrointestinal tumors

AbstractGastrointestinal (GI) tumors have always been a major type of malignant tumor and a leading cause of tumor‐related deaths worldwide. The main principles of modern medicine for GI tumors are early prevention, early diagnosis, and early treatment, with early diagnosis being the most effective measure. Endoscopy, due to its ability to visualize lesions, has been one of the primary modalities for screening, diagnosing, and treating GI tumors. However, a qualified endoscopist often requires long training and extensive experience, which to some extent limits the wider use of endoscopy. With advances in data science, artificial intelligence (AI) has brought a new development direction for the endoscopy of GI tumors. AI can quickly process large quantities of data and images and improve diagnostic accuracy with some training, greatly reducing the workload of endoscopists and assisting them in early diagnosis. Therefore, this review focuses on the combined application of endoscopy and AI in GI tumors in recent years, describing the latest research progress on the main types of tumors and their performance in clinical trials, the application of multimodal AI in endoscopy, the development of endoscopy, and the potential applications of AI within it, with the aim of providing a reference for subsequent research.

Achievements and development of endoscopy in coloproctology

Modern developments and achievements in the field of endoscopy are inextricably linked with related clinical specialties, and their evolutionary development leads to an increase in the detection of diseases at an early stage and the improvement of surgical organ-preserving methods of treatment, thereby contributing to the preservation of health and improving the quality of life of patients.

Applications of navigation in full-endoscopic spine surgery.

Advancement in all surgery continues to progress towards more minimally invasive surgical (MIS) approaches. One of the platform technologies which has helped drive this trend within spine surgery is the development of endoscopy; however, the limited anatomic view experienced when performing endoscopic spine surgery requires a significant learning curve. The use of intraoperative navigation has been adapted for endoscopic spine surgery, as this provides computer-reconstructed visual data presented in three dimensions, which can increase feasibility of this technique to more surgeons. This paper will describe the principles, technical considerations, and applications of stereotactic navigation-guided endoscopic spine surgery. Full-endoscopic spine surgery has advanced in recent years such that it can be utilized in both decompressive and fusion surgeries. One of the major pitfalls to any minimally invasive surgery (including endoscopic) is that the limited surgical view can often complicate the surgery or confuse the surgeon, leading to longer operative times, higher risks, among others. This is the real utility to using navigation in conjunction with the endoscope-when registered correctly and utilized appropriately, navigated endoscopic spine surgery can take some of the guesswork out of the minimally invasive approach. Using navigation with endoscopy in spine surgery can potentially expand this technique to surgeons who have yet to master endoscopy as the assistance provided by the navigation can alleviate some of the complexities with anatomic understanding and surgical planning.

Full Endoscopic Posterior Cervical Laminoforaminotomy and Discectomy: A Technical Note

Cervical disc herniations affects different age groups especially the young population with habits of a sedentary lifestyle, long working hours over the computer, and poor neck postures who present with acute disc herniations. Cervical radiculopathy commonly presents with pain, paresthesia and motor weakness. Traditional surgical options available are anterior Cervical Discectomy and Fusion (ACDF) and Posterior Cervical Foraminotomy (PCF). However both the procedures have some disadvantages. With evolution of endoscopy in recent times provide better opportunity. Here we mention Full Endoscopic posterior cervical laminoforaminotomy and discectomy technique. It is the most advanced technique for single-level lateral and foraminal disc prolapses causing monoradiculopathy, we found this procedure is safe and effective minimally invasive technique for lateral soft herniations and foraminal stenosis. It has lesser complications and better post-op recovery.

The Frequency of H. Pylori Infection Among Patients Experiencing Digestive Endoscopy a Multi Center Study

Background: The development of endoscopy, particularly gastroscopy, has changed the diagnosis of oeso-gastroduodenal disorders. there is little information accessible on the methods of intestinal endoscopy. Objective: The study's goal was to evaluate the pathologic diagnosis of endoscopic lesions and the presence of H. pylori during endoscopy (digestive examination). Methodology: 100 patients participated in the study, and there were 42 men and 58 women in it. This Multi center study was done department of gastroenterology and medical department hmc and lrh Peshawar between May 2022 and November 2022. The patients freely signed the permission form after being made informed of the goal. The data from each patient's gastrointestinal endoscopy were gathered for analysis. The research was authorized by the ethics and review committees of our institute's teaching hospital. The patients who had gastrointestinal endoscopies were included in this study by the inclusion criteria. Results: According to data, more female patients than male patients sought medical treatment for this problem. It was also observed that patients under the age of 45 comprised a greater percentage of the patient group than patients over the age of 45. Epigastralgia, which was reported by 72% of patients, was the most frequent sign and symptom, according to the data. Vomiting was the next most prevalent symptom, followed by gastrointestinal bleeding and weight loss. Several patients simultaneously reported many of these symptoms. Esophageal varices were shown to be associated with males, with a significant p-value of 0.045, it was discovered. The H. pylori-related gastritis was connected to a lesion. Conclusion: The study's objective was to determine the prevalence of H. pylori infection and the characteristics of endoscopic lesions in patients having gastrointestinal endoscopies. Analysis was done to determine the impact of different endoscopic lesions on various demographic parameters in this retrospective study. Age and stomach tumors were shown to be connected, and smoking may have had some influence on the development of peptic ulcers. And the majority of patients had an upper gastrointestinal endoscopy regularly. Keywords: H. Pylori infection, digestive endoscopy,

Adequate Management of Postoperative Complications after Esophagectomy: A Cornerstone for a Positive Outcome.

Esophagectomy for cancer is one of the most complex procedures in visceral surgery. Postoperative complications negatively affect the patient's overall survival. They are not influenced by the histology type (adenocarcinoma (AC)/squamous cell carcinoma (SCC)), or the surgical approach (open, laparoscopic, or robotic-assisted). Among those dreadful complications are anastomotic leak (AL), esophago-respiratory fistula (ERF), and chylothorax (CT). In this review, we summarize the methods to avoid these complications, the diagnostic approach, and new therapeutic strategies. In the last 20 years, both centralization of the medical care, and the development of endoscopy and radiology have positively influenced the management of postoperative complications. For the purpose of their prevention, perioperative measures have been applied. The treatment includes conservative, endoscopic, and surgical approaches. Post-esophagectomy complications are common. Prevention measures should be known. Early recognition and adequate treatment of these complications save lives and lead to better outcomes.

Preoperative emobilisation of juvenile nasopharyngeal angiofibroma

IntroductionJuvenile nasopharyngeal angiofibroma(JNA) are highly vascular benign tumours originating in the sphenopalatine fossa and may extend to the pterygopalatine fossa, paranasal sinuses, and nasal cavity. The management of JNA has evolved greatly with development of endoscopy. Treatment modality has changed from open approach to endoscopic approach due to various advantages offered by the endoscopic approach. Bleeding during the surgery can compromise the exposure and surgical excision of JNA endoscopically. There have been many techniques to decrease intraoperative bleeding including external carotid ligation, hypotensive anaesthesia and more recently embolization of the feeding vessels. Embolization of the tumour has made the endoscopic excision of JNA easier because of less bleeding. This study was taken to find out the outcomes of surgical excision of JNA after embolization. MethodologyWe retrospectively reviewed 22 histopathological proven JNA cases that underwent preoperative embolization followed by resection during the period of June 2015 to December 2020 in our tertiary care hospital. From the records demographic, clinical, radiological imaging (CECT nose and PNS), angiographic, pre-operative embolization and operative details were evaluated. ResultIn the present study a total of 22 cases of angiofibroma were taken up for surgical excision after embolization. A complete endonasal endoscopic resection could be done in 21/22 cases with average operative time of 141 minutes (80 minutes-190 minutes range). The mean blood loss during surgery was 1163 ml (Range 500 ml- 1900 ml). In 7/22 (31.81%) subjects required intraoperative blood transfusion. No perioperative surgical complications occurred. ConclusionEndoscopic excision of JNA has now become the primary operative technique and pre operative embolization in such cases can reduce the intraoperative time, blood loss and tumour relapse rate. It is a relatively safe procedure in a hand of an expert and must be done where ever available.

Foundations in Spinal Endoscopy

Spinal endoscopy has revolutionized the way spine surgeons deliver minimally invasive care for appropriately selected patients. The evolution of endoscopy has been tumultuous since its beginnings as a "blind" percutaneous procedure to access the disk until the present state, in which complex decompressions and even fusions can be accomplished through subcentimeter incisions. Engineering has played a crucial role in this evolution with advances in optics, illumination, and instrumentation that have allowed surgeons to work safely and efficiently in smaller and smaller corridors. Finally, the adaptation of enhanced recovery after surgery protocols have complemented the benefits offered by spinal endoscopy to help patients return to the quality of life they seek through surgical intervention. In this article, we explore foundational elements of spinal endoscopy and look ahead to the future of this maturing field.

Can We Identify Patients in Danger of Complications in Retrograde Intrarenal Surgery?-A Retrospective Risk Factors Analysis.

Retrograde intrarenal surgery (RIRS) is an innovative and effective method of kidney stones treatment, as it had great influence on the development of endoscopy in urology. The increasing prevalence of urolithiasis together with the rapid development of endourology leads to a rise in the number of procedures related to the disease. Flexible ureteroscopy is constantly being improved, especially regarding the effectiveness and safety of the procedure. The purpose of this study is to evaluate intraoperative and early post-operative complications of RIRS in the treatment of kidney stones. A retrospective analysis of medical records was performed. A series was comprised of 207 consecutive operations performed from 2017 to 2020. Complications occurred in 19.3% (n = 40) of patients. Occurrence according to the Clavien-Dindo scale was: 11.1% for grade I, 5.8% for grade II and 2.4% for grade IV. Infectious complications included SIRS (5.3%, n = 11) and sepsis (2.4%, n = 5). Statistical analysis revealed a correlation between acute post-operative infections and positive midstream urine culture, history of chronic or recurrent urinary tract infections, and increased body mass index (BMI). Furthermore, a significant correlation was observed between pain requiring the use of opioids with BMI over 25. Consequently, history of urinary tract infections, positive pre-operative urine culture, and increased BMI are considered risk factors and require appropriate management.

Endoscopic transforaminal lumbar interbody fusion: Technical note

With recent advanced tools in hands, spine surgery is leaping towards the whole new era, conventional open spine surgeries are being replaced by the minimally invasive endoscopic spine procedures. With evolution of endoscopy, long list of objectives is possible to achieve like minimize the trauma of surgery and the reductions of surgical blood loss, hospital stay, and complication rates. Traditional open lumbar fusion surgery and in last decade minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) have become the standard treatment for the lumbar spine disorders. However, MIS-TLIF techniques still require an access through musculature for tube placement with considerable trauma to the musculature and bone resection. Thus, MIS-TLIF represents an incremental but not revolutionary advancement over the existing open surgical methods. With endoscopy-assisted transforaminal/transkambian Interbody fusion with MIS spine fixation provides a better and minimally invasive way of TLIF. In this article, we will discuss the technique of Endo TLIF, pearls, and pitfalls.

Endoscopic stenting for esophageal anastomoses leakage (review of literature)

Esophageal anastomoses leakage is a serious and urgent problem of surgical complications with high mortality rates. With the development of endoscopic technologies, minimally invasive methods of treatment are widely introduced into clinical practice with the development of endoscopic technologies in various non-standard situations, including esophageal anastomoses leakage. Stenting is one of the methods of choice in this case. However, the indicators of their effectiveness differ significantly across studies. A retrospective analysis of the stenting results in this severe complication demonstrates many factors influencing the success of esophageal stent implantation. Stents are often selected without due regard to their characteristics, which may affect the results of implantation. One of the most frequent and unfavorable outcomes of stenting is stent migration, which significantly affects the prognosis of the treatment. In this regard, in Russian practice, stenting, as a method of treating for esophageal anastomoses leakage, is introduced only in some institutions. However, many complications can be avoided at present due to the development in endoscopy and the constant improvement of stent designs. The objective of this review was to highlight the main advantages and problemsof stenting in esophageal anastomoses leakage today.

Endoscopy in surgery.

In the last 20 years, there have been important developments in endoscopy. Initially, endoscopy was developed and used as a diagnostic tool. As new technology developed, these devices also became the basis for therapeutic maneuvers. In recent years, flexible endoscopes have been used to per- form procedures replacing traditional surgical approaches. Examples of this field are transanal minimally invasive surgery, natural orifice transluminal endoscopic surgery, endoscopic metabolic surgery and third space endoscopies. Throughout history, surgeons have played a vital role in the design and development of endoscopic techniques, procedures, and equipment. Surgeons continue to lead the advancement of endoscopy, make important contributions, and serve as role models for innovation.

A Review of Minimally Invasive Techniques in Thoracolumbar Trauma

AbstractThe development of endoscopy, microscopy, and image guidance system provided the impetus for the adoption of minimally invasive surgery (MIS) techniques in the management of spinal trauma patients. The underlying drive has been an attempt to achieve the functional and biomechanical goals inherent to trauma care but through MIS techniques. Broadly the MIS techniques for spinal trauma can be divided into two categories—fusion and nonfusion methods. Fusion methods include mini-open or keyhole approaches that allow for discectomy and/or corpectomy and cage reconstruction via an anterior/lateral/posterior operative corridor. The nonfusion methods primarily include percutaneous pedicle screw fixation, kyphoplasty, and vertebroplasty, all without placement of bone graft or other attempts at inducing arthrodesis. In this review article, we have stratified the MIS techniques based on the operative corridor used and briefly described the decision-making process, technical nuances, pros, and cons of each technique.

Therapeutic and diagnostic enteroscopy in children: 15 years of experience

Each new stage in the development of endoscopy was characterized by the creation of more sophisticated equipment and the expansion of diagnostic capabilities. The 21st century was marked by the transition to robotic remotely controlled endoscopic systems, the use of digital or electronic endoscopic technology in children. The modern level of endoscopy in pediatrics includes a high definition of the image obtained, a morphological study of biopsy specimens and a full range of endosurgical procedures. The paper presents the experience of introducing, teaching, preparing, conducting, analyzing and evaluating the results, features and nuances of use in children of therapeutic and diagnostic enteroscopy of a new generation: video capsule endoscopy and double-balloon enteroscopy. The modern approach to intraluminal diagnosis and endoscopic treatment of children with digestive system pathologies is substantiated.

Contributions from Japan to gastrointestinal endoscopy training and development: Special report.

Contributions from Japan to gastrointestinal endoscopy training and development: Special report.

Artificial Intelligence in Gastrointestinal Endoscopy.

Artificial intelligence (AI) is rapidly integrating into modern technology and clinical practice. Although in its nascency, AI has become a hot topic of investigation for applications in clinical practice. Multiple fields of medicine have embraced the possibility of a future with AI assisting in diagnosis and pathology applications.In the field of gastroenterology, AI has been studied as a tool to assist in risk stratification, diagnosis, and pathologic identification. Specifically, AI has become of great interest in endoscopy as a technology with substantial potential to revolutionize the practice of a modern gastroenterologist. From cancer screening to automated report generation, AI has touched upon all aspects of modern endoscopy.Here, we review landmark AI developments in endoscopy. Starting with broad definitions to develop understanding, we will summarize the current state of AI research and its potential applications. With innovation developing rapidly, this article touches upon the remarkable advances in AI-assisted endoscopy since its initial evaluation at the turn of the millennium, and the potential impact these AI models may have on the modern clinical practice. As with any discussion of new technology, its limitations must also be understood to apply clinical AI tools successfully.

Endoscopic Optic Nerve Decompression: Indications, Technique, Results

For decades, treatment of compressive optic nerve neuropathy was conservative and involved the intravenous application of high-dose corticoids, which was combined with nerve growth factors in later years. If surgery was considered, transcranial and transfacial access to the orbital apex and the optic nerve were achieved using classical approaches. Over the past decade, endonasal endoscopic procedures have increasingly come into force, based on favorable experiences with functional endoscopic sinus surgery and as a result of innovative developments in endoscopy and image guidance. The purpose of this review is to address the latest literature in this field with regard to the indications, techniques, results, and complications associated with this procedure. There are basically two approaches for endoscopic optic nerve decompression: the extradural supraorbital “keyhole” approach, which provides access to the optic nerve canal roof and which is usually performed by neurosurgeons, and the endonasal endoscopic approach, which is widely used by otorhinolaryngologists. The development and application of endonasal endoscopic surgery was only possible with extensive knowledge of the topographic anatomy. The most important anatomical landmarks and topography have been described based on either cadaveric or CT scan studies, and include the opticocarotid recess, the distance between the optic nerve canal and the internal carotid artery, the ophthalmic artery, and the length of the optic nerve canal. There are two main indications for endonasal endoscopic optic nerve decompression: (1) traumatic optic nerve neuropathy (TON), and (2) optic nerve neuropathy from non-traumatic causes (nTON), such as tumorous conditions, inflammatory diseases, or idiopathic intracranial hypertension (IIH). In trauma cases, rates of postoperative visual improvement of 40–80% have been reported. Factors influencing the outcome include the severity of the injury, initial visual acuity (light perception or better vs. no light perception), the time interval between trauma and intervention, and the type of injury, such as fracture lines directly through the optic nerve canal or probable avulsion trauma. nTON cases generally have a slightly better prognosis, with vision improvement of 54–100% reported. The procedure should be performed before any optic nerve atrophy can occur. In IIH cases, all major symptoms, including vision loss, headache, visual field deterioration, and papilla edema, improved after optic nerve decompression, with rates of 60–100% reported. Earlier studies reported the occurrence of major complications such as cerebral fluid leakage, severe hemorrhage, or optic nerve injury at rates of about 3%. However, more recent studies postulate that no major complications occur, which may reflect the increasing use of the endonasal endoscopic route to the optic nerve and skull base as standard procedure, so that surgeons are becoming more comfortable with the technique. Endonasal endoscopic optic nerve decompression is a safe and highly effective treatment to reduce hydrostatic pressure on the optic nerve in cases of optic nerve neuropathy of various etiologies. In TON cases, about 50% of patients will benefit from the procedure, with vision improvement possible in some cases even with an interval of some days between trauma and surgery. Non-trauma cases have a slightly better prognosis. The intervention should be performed prior to optic nerve atrophy.

Hallazgos histológicos de biopsias obtenidas por endoscopia digestiva superior en el paciente pediátrico

Antecedentes: El desarrollo de la endoscopia ha dado pasos agigantados en el campo de la gastroenterología pediátrica, convirtiéndose en una prueba diagnóstica de primera línea por la posibilidad de toma de biopsia, además se ha consolidado como un tratamiento eficaz en numerosas enfermedades digestivas. Objetivo: revisar los hallazgos histológicos de biopsias obtenidas por endoscopia digestiva superior en el paciente pediátrico del Hospital Nacional Dr. Mario Catarino Rivas (HNMCR) en el período comprendido entre enero a mayo 2016. Pacientes y métodos: Estudio transversal, descriptivo, realizado en pacientes con edades comprendidas entre 28 días y 18 años. Se revisaron 40 biopsias que cumplían los criterios de inclusión. Los datos se obtuvieron de los archivos de biopsias del servicio de patología, posteriormente se hizo un análisis estadístico de las variables. Resultados: se revisaron 40 biopsias, 55% hombres, 45% mujeres, el 47.5% de los pacientes eran adolescentes. La indicación mas común fue el dolor abdominal crónico (33%), seguido por la gastritis crónica (28%) y reflujo gastroesofágico (20%). Los hallazgo histopatológico más frecuente fueron la gastritis crónica 43%, esofagitis crónica 30% y el Helycobacter Pylori 13%. Conclusión: En el 95% de las biopsias realizadas se encontraron anormalidades, siendo el más frecuente la gastritis crónica. Palabras clave Endoscopía, gastritis crónica, hallazgos histológicos

Endoscopy and sedation: an inseparable binomial for the gastroenterologist.

The development of endoscopy and its increasing demand among the population have led to a growing need for propofol-based sedation techniques. Benefit is indisputable for both patients and endoscopists, but some aspects require considering the "who" and "how" of sedation as related to safety and health care costs. Propofol is first-choice in endoscopy for the European Society of Gastrointestinal Endoscopy because of its fast onset of action and short half-life, and many reports exist on its safety when used by gastroenterologists rather than anesthesiologists. In this issue of REED several originals support the efficiency and safety of propofol even for complex, high-risk, or protracted procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and enteroscopy. Propofol may be safely and effectively administered by a team with specific skills acquired through education and using a specific procedure. However, difficulties arise in real-world clinical practice that preclude such training, which in Spain should be included in the MIR (médico interno residente) specialization program curriculum. The Comisión Nacional de Digestivo (Spanish National Commission on Digestive Diseases), sensitive to this training gap, has included in their latest version of the MIR program (under assessment) four additional competences, with number 145 (training in deep sedation) being most relevant here. In addition, the Spanish Society of Gastrointestinal Endoscopy (SEED) has invested significant efforts in sedation training, with over 50 courses on sedation for endoscopists and nurses. Continuing education and training in this field (for instance, refresher courses on advanced cardiopulmonary resuscitation) should be a goal for all endoscopy units. Because of the diversity found among hospitals, with single or multiple endoscopy rooms, efforts should be made to persuade those in charge of gastroenterology and anesthesiology departments to establish the necessary care circuits in order to guarantee patient safety by developing accurate protocols and promoting consensus among the scientific societies involved (Spanish Society for Digestive Diseases [SEPD], SEED and Spanish Society of Anaesthesiology, Resuscitation and Pain Management [SEDAR]) and their respective national commissions.

OC-042 Benefits of Service Redesign with a Tertiary Symptomatic Colorectal EMR Service Managed within Bowel Cancer Screening Service Model: Abstract OC-042 Table 1

Introduction One of the high quality service developments in endoscopy in the UK has been the introduction of the Bowel Cancer Screening Programme due to the rigorous quality assurance not just of the colonoscopy but of all aspects of the patient journey. Whilst the Royal Liverpool is a tertiary referral site for colorectal complex polyp/Endoscopic Mucosal Resection for BCSP and the symptomatic service for the North-West, the patient journey and quality of service varied significantly depending whether they were referred through via the BCSP or the symptomatic route. Methods We modelled the patient pathway within the symptomatic service to the BCSP standard of care. We seconded two SSPs and BCSP admin to work 50% with the EMR service and 50% within BCSP. All referrals were initially reviewed by EMR specialist endoscopists and then handed to the SSPs to be entered onto a bespoke database. Telephone assessment of patients was performed by an SSP who actively managed the patients co-morbidities and charted them on the database. Patients were listed onto dedicated EMR lists with adequate slot allocations as determined by the EMR endoscopist. Post procedure, patients had a follow-up phone call and their histology and post discharge follow up was monitored and managed by the team including MDT handover in the referral centres. Results Since the start of the service (24 th August 2015) 138 patients have been managed through the service. The mean age was 77 years. Referral pathways have included:51% external tertiary referrals, 6% from MDT and 43% internal tertiary referrals. 31 telephone assessments have been performed. In 25% patients a successful intervention by the team resulted in a positive outcome. These included interventions in; Pre-procedure work up & management of co-morbidities (n = 14), administration (n = 12), post-procedure complications (n = 5) and change in management following histology results (n = 3). See Table for full details Conclusion Re-design of the symptomatic EMR service using the expertise within our BCSP with similar principles in pathway management has had a significant impact on patient safety and outcomes within this service. Disclosure of Interest None Declared