Wire Snare Research Articles

Removal of jammed loop cutter and residual snare wire, after polypectomy with a detachable snare

Removal of jammed loop cutter and residual snare wire, after polypectomy with a detachable snare

Endobronchial electrocautery wire snare prior to right middle sleeve lobectomy for adenoid cystic carcinoma of the lung: a case report

Abstract Background Adenoid cystic carcinoma of the lung grows gradually, and spreads along the bronchial wall, often requiring tracheobronchoplastic procedure during surgery; however, incomplete resection occasionally occurs due to positive surgical margins. To avoid incomplete resection, effort should be exerted to confirm the extent of airway invasion of the tumor before surgery. Herein, we present the utility of combined treatment with bronchoscopic electrocautery wire snare for the endobronchial tumor prior to sleeve lobectomy with curative resection for patients with adenoid cystic carcinoma of the lung. Case presentation A 56-year-old woman experienced a persistent cough 6 months prior. On an annual medical checkup, an abnormal lung shadow was noted. Chest computed tomography (CT) scan demonstrated right middle lobe atelectasis, and a round tumor shadow at the orifice of the right middle lobe bronchus, which protruded into the right intermediate bronchus, was observed. On bronchoscopy, a pedunculated endobronchial tumor in the intermediate bronchus was shown, and the middle lobe bronchus was completely obstructed. Initially, tumor resection via bronchoscopy was performed using an electrocautery wire snare under general anesthesia, and the tumor was pathologically diagnosed as adenoid cystic carcinoma of cT1aN0M0 stage IA. After tumor resection, the extent of tumor progression in the airway was assessed; subsequently, the patient underwent elective right middle sleeve lobectomy and lymphadenectomy. She survived without recurrence 7 years after surgery. Conclusion We present a useful combined treatment strategy of bronchoscopic electrocautery wire snare prior to sleeve lobectomy for patients with endobronchial adenoid cystic carcinoma of the lung.

Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate

Background Intravascular foreign bodies (IFB) in severely preterm neonates present critical clinical challenges. Traditional surgical removals are often risky and may not be feasible in these patients. This case report aims to detail a successful endovascular approach for IFB retrieval in a severely preterm neonate. Case This is a case report of a 14-day old, male 30-week gestation neonate with a retained umbilical catheter fragment. The baby was referred after an unsuccessful explorative laparotomy by a paediatric surgery team. The endovascular procedure was performed using a 4 French (Fr) vertebra catheter and a One Snare wire in the right femoral region under low-dose fluoroscopy. The IFB was successfully removed. Post-procedure, the patient’s leukocyte count normalized, and he transitioned from ventilator support to a nasal cannula and eventually to room air within three days. The neonate could also tolerate oral intake, signalling a rapid recovery and low morbidity. Conclusions This case report highlights the potential of endovascular approaches for IFB retrieval as viable alternatives to traditional surgeries, especially in neonates where surgical options are limited or have failed. Further research is needed to standardize such minimally invasive techniques in neonatal care.

Assessing Threats to the Drill monkey (Mandrillus leucophaeus) and other Primate Species in Selected Ranges of Cross River National Park, Nigeria

The population of the endangered drill monkey (Mandrillus leucophaeus) and other primate species have continued to decline in Cross River National Park (CRNP), Nigeria. The current threats responsible for the population decline was assessed in four selected ranges (Anape, Aking Orem and Nsofang) through administrative park record, interview of hunters and field observations that spanned 194days (between July, 2021 – August, 2022) covering a distance of 997km. A total of 58 interviews of hunters were conducted in seven communities (Anape, Aking, Osomba, Orem, Ntebachot, Nsofang and Mkpot). Ninetyfive (95%) reported a decline in the population of the drill monkey as (65%) stated a rare encounter. Also, 90% reported to hunt primates with 64% reporting to hunt drill monkey even though they are aware of the existence of CRNP. However, 79% expressed their willingness to stop hunting if an alternative livelihood was provided. Thirteen threat indicators were recorded in both season (wet and dry), distributed across the four ranges surveyed. Spent cartridge (dry=12.75±10.41; wet=6.25±5.91), wire snare (dry=8.25±4.73; wet=8.5±3.42) and logging (dry=3.75±3.61; wet=3.50±2.65) were the highest threat indicators and correlated with the administrative record on threat in a ten year period (2012 -2021) (hunting 34.3% and logging 35.5%). Encounter rate of threat was highest in Nsofang (dry=0.78/km; wet=0.76/km) which harbours an enclave community (Mkpot) and lowest at Anape (dry=0.05/km; wet=0.18/km) suggesting more protection of this area considering the conservation interest in the region. The Park authority is therefore implored to intensify protection efforts in these other areas with high anthropogenic activities while considering the possibility of a joint forest management with host communities.

Wire Snare Close Loop: A Novel Technique to Retrieve Embolized Devices

Wire Snare Close Loop: A Novel Technique to Retrieve Embolized Devices

Combined Endovascular Antegrade and Direct Retrograde Carotid Artery Stenting for Chronic and Long Segment Common Carotid Artery Occlusion: Technical Note and Review of Literature.

Common carotid artery (CCA) occlusion (CCAO) is a rare cause of ischemic stroke and bypass surgery is the common treatment approach. However, safer alternatives should be developed to treat CCAO. A 68-year-old male was diagnosed with left-sided CCAO with decreased left visual acuity due to neck radiation therapy for laryngeal cancer. Recanalization therapy using a pull-through technique was initiated because cerebral blood flow progressively decreased during the follow-up period. First, after a short sheath was inserted into the CCA, the occluded CCA was retrogradely penetrated through the sheath. Second, a micro-guidewire was guided to the aorta from the femoral sheath where it was caught using a snare wire guided from the cervical sheath. Subsequently, the micro-guidewire was gently pulled out from the cervical sheath, penetrated the occluded lesion, and was secured to the femoral and cervical sheaths. Finally, the occluded lesion was dilated using a balloon, and the stent was placed. Five days postprocedure, the patient was discharged uneventfully and exhibited improved left visual acuity. In terms of reliable penetration of obstructive lesions and reduction of embolic and hemorrhagic complications, combined endovascular antegrade and direct retrograde carotid artery stenting is a versatile and minimally invasive treatment option for CCAO.

A framework for assessing animal behavioural responses to wire snare poaching

Wire snares are among the most common and widely-used techniques for illegal harvesting of terrestrial animals around the world. Recent research has documented the mortality effects of wire snare poaching on animal populations, but the indirect impacts on the behaviour of surviving individuals remain largely uninvestigated. We know little about the short- and long-term effects of snaring injury on the behaviour of animals that survive wire snares. Here, we present a framework for assessing animal behavioural responses to wire snare poaching. Via the framework, we highlight the physiological mechanisms underlying animal responses to being captured, and identify the behaviours affected when animals escape entrapment with injury. We use evidence from mammal species that are vulnerable to wire snaring to highlight the short- and long-term effects of snaring injury on individual animal behaviour, and how they can potentially scale to have population-level consequences. The framework can be used to evaluate the nature of animal behavioural responses to being captured in snares and the resultant effects on their fitness and survival. We identify priorities for research as well as management actions to mitigate the impacts of snare injury on animals that survive wire snares.

Rectal Foreign Body Successfully Removed by Colonoscopic Snare Wire

Aim: The most common cause of rectal foreign bodies are objects used for sexual stimulation voluntarily by the patient. Different treatment methods are reported in the literature, and this article reports the transanal removal of the foreign body in the rectum with a snare wire without anesthesia, accompanied by colonoscopy. Case: An 80-year-old male patient was admitted to the emergency room because of the plastic rectal shower head that remained in the rectum and could not be removed while he was using a rectal douche for constipation. Contrast-enhanced abdominal computed tomograpyh (CT) showed a foreign body located in the rectosigmoid region without perforation findings. 12x1,5 cm tubular, well-circumscribed plastic foreign body embedded in the stool was removed with the help of colonoscopy in a controlled manner by holding it from its distal end with the help of endoscopic snare wire. Conclusion: Rectal foreign bodies can often be removed by the patient. However, in cases of foreign bodies in the rectum admitted to the hospital, the treatment method varies according to the type and location of the object, the occurrence of the event, and whether there are perforation findings in physical examination and imaging. Digital rectal examination is the critical first step in evaluating a patient with a rectal foreign body. Bedside extraction as the first-line treatment for low-lying anorectal foreign bodies without signs of perforation; endoscopic extraction is recommended as the first step in anorectal foreign bodies located high above the rectosigmoid junction. Because in cases without perforation, transanal removal of the foreign body is considered the first-line treatment and the success rate is approximately 75 %. The most essential condition for successful transanal removal of the foreign body in the rectum is the relaxation of the patient. Endoscopic examination is also recommended to evaluate the condition of the intestinal wall after the removal of the foreign body. In our case, we also removed the foreign body, which we found to be located in the middle rectum, in accordance with the literature, endoscopically.

Use of etorphine hydrochloride for immobilisation of Nubian giraffe for wire snare removal: a retrospective study

Use of etorphine hydrochloride for immobilisation of Nubian giraffe for wire snare removal: a retrospective study

Editorial: Optimizing the success of cold snare polypectomy in colonoscopy practice

Editorial: Optimizing the success of cold snare polypectomy in colonoscopy practice

Capture methods of Caiman latirostris Daudin, 1802 (Crocodylia, Alligatoridae) in northern Uruguay, with notes of defensive and feeding behaviours

Caiman latirostris is a Neotropical crocodilian for which there is scarce natural history information in regard to other species, as also about survey methods used by field researchers. In this work we report the capture methodology implemented during population monitoring in northern Uruguay and some observations about defensive and feeding behaviours. We found the use of a metallic clamp as very useful for capturing juveniles and subadult individuals (< 120 cm total length) in vegetated habitats, while a wire snare was used for adults. Regardless locomotor escape, we provide a reappraisal of defensive behaviours in the presence of humans, with particular comments on tonic immobility. In addition, we suggest an apparent case of carcass consumption (scavenging) for the species, a presumedly common behaviour but sometimes hard to observe in wild crocodilians.

Evaluating the effects of giraffe skin disease and wire snare wounds on the gaits of free-ranging Nubian giraffe

Giraffe skin disease (GSD), a condition that results in superficial lesions in certain giraffe (Giraffa spp.) populations, has emerged as a potential conservation threat. Preliminary findings suggested that individuals with GSD lesions move with greater difficulty which may in turn reduce their foraging efficiency or make them more vulnerable to predation. A current known threat to some giraffe populations is their mortality associated with entrapment in wire snares, and the morbidity and potential locomotor deficiencies associated with wounds acquired from snares. The goal of our study was to quantify the locomotor kinematics of free-ranging Nubian giraffe (G. camelopardalis camelopardalis) in Murchison Falls National Park (MFNP), Uganda, and compare spatiotemporal limb and neck angle kinematics of healthy giraffe to those of giraffe with GSD lesions, snare wounds, and both GSD lesions and snare wounds. The presence of GSD lesions did not significantly affect spatiotemporal limb kinematic parameters. This finding is potentially because lesions were located primarily on the necks of Nubian giraffe in MFNP. The kinematic parameters of individuals with snare wounds differed from those of healthy individuals, resulting in significantly shorter stride lengths, reduced speed, lower limb phase values, and increased gait asymmetry. Neck angle kinematic parameters did not differ among giraffe categories, which suggests that GSD neck lesions do not impair normal neck movements and range of motion during walking. Overall, MFNP giraffe locomotor patterns are largely conservative between healthy individuals and those with GSD, while individuals with snare wounds showed more discernible kinematic adjustments consistent with unilateral limb injuries. Additional studies are recommended to assess spatiotemporal limb kinematics of giraffe at sites where lesions are found predominantly on the limbs to better assess the potential significance of GSD on their locomotion.

Comparison of complete resection rates in cold snare polypectomy using two different wire diameter snares: A randomized controlled study.

Cold snare polypectomy (CSP) is a standard treatment for small colorectal polyps. This study examined the effect of different snare wire diameters on complete histological resection rate, resection depth, and CSP safety. This randomized controlled trial was conducted at two institutions between June 2019 and March 2021. Eligible colorectal polyps (≤10mm) were randomly assigned in a 1:1 ratio to receive either CSP with a conventional snare made of normal-diameter wire (0.40mm) or CSP with a dedicated snare made of thin wire (0.23mm). The primary endpoint was the complete resection rate determined on histological assessment of the resected specimen. In total, 254 lesions in 152 patients were included, with 128 and 126 lesions assigned to the normal-diameter wire snare group and the thin-wire snare group, respectively. No significant differences were observed in patient characteristics between the two groups. The histological complete resection rate was significantly higher in the thin-wire snare group than in the normal-diameter wire snare group (70.0% vs 81.0%, P=0.04). The normal-diameter wire snare group had significantly more cases of unclear horizontal margin evaluation than the thin-wire snare group (28.1% vs 15.9%, P=0.02). No significant differences were observed between the two groups in the muscularis mucosa and submucosa of the resected specimens or the thickness of the submucosa in the resected specimens. CSP with a dedicated thin-wire snare provides more specimens that can be evaluated at the horizontal end and increases the histological complete resection rate.

Evaluating the prevalence and spatial distribution of giraffes injured by non‐target poaching

AbstractIllegal harvest (poaching) is a geographically widespread threat to animal populations. Wire snares are a common poaching technique used in the Global South and are indiscriminate with respect to species, age, and sex of individual animals that they capture. When caught, relatively large mammals frequently break free from the snares, suffering injuries in the process. The prevalence of snaring injuries as well as the ecological and conservation implications of such patterns have not been widely investigated for many animal populations. We evaluated the prevalence and spatial distribution of giraffes (Giraffa camelopardalis) with snaring injuries in Murchison Falls National Park, Uganda, a system experiencing high rates of wire snare poaching. We conducted photographic spatial encounter surveys along five fixed road transects. We photographed detected giraffes, recorded whether a snaring injury was present, and identified individuals via autonomous image processing of pelage patterns. We fitted a spatial capture‐recapture (SCR) model to the encounter history data to estimate abundance and predict the spatial distribution of injured giraffes. We detected 1306 (sub) adult giraffes from the surveys and predicted 1939 (±80) via the SCR model. We encountered 26 giraffes with snaring injuries, corresponding to a population‐level snaring rate of 1.4%. Individuals with higher movement scales were more at risk of being snared. Though not fatal across the three‐month duration of this study, the injuries likely lead to secondary infections, disability, and potentially death in the long term. We explore the implications of bearing snaring injuries for ecology, behavior, and conservation of affected species.

Abnormal foreshortening of a Flow Re-Direction Endoluminal Device caused by in-stent thrombosis immediately after deployment.

Thromboembolic complications are a concern in the treatment of cerebral aneurysms using a flow diverter. In this study, we report a case of abnormal foreshortening of a Flow Re-Direction Endoluminal Device (FRED) caused by in-stent thrombosis immediately after its deployment. A 72-year-old woman had a large cavernous carotid aneurysm, which caused ptosis and diplopia. FRED deployment was planned, and dual antiplatelet therapy was initiated 2 weeks before the procedure. Under systemic heparinization, FRED was deployed with local compaction over the aneurysm orifice. Cone-beam computed tomography subsequently revealed slightly poor wall apposition at the proximal side. While the balloon catheter was prepared for angioplasty, the stent became abnormally foreshortened, the proximal side slipped into the aneurysm, and the internal carotid artery became occluded. FRED was removed using a snare wire, and recanalization was obtained. The lumen of the removed FRED was filled with thrombus. The antiplatelet therapy was changed to triple regimen, and a Pipeline Flex embolization device was placed 1 month later. At that time, no thromboembolic complications were noted. It was considered that thrombotic occlusion was followed by foreshortening of FRED on the distal side because of antegrade blood flow. Multiple factors, such as increased mesh density by locally compacted stent deployment, slightly poor wall apposition, clopidogrel resistance, and the dual-layer structure of FRED, may have been involved in thrombus formation.

S2133 Suck and Snare: A Technique for Rapid, Complete, and Safe Cold Snare Polypectomy of Sessile Polyps Greater Than One Centimeter

Introduction: Snare polypectomy of flat colon polyps may be challenging when boarders are indistinct or if the snare wire slides over the flat mucosal surface as the snare closes. Current guidelines suggest cold or hot snare polypectomy with or without submucosal injection for the removal of polyps between 1 and 1.9 centimeters (cm). Injection lift polypectomy and hot snare endoscopic mucosal resection of flat lesions can be time intensive and carries risks of perforation, post polypectomy syndrome, and bleeding. Cold snare technique has become increasingly utilized for Paris class 1s and 1sp polyps of any size. We propose an adaptation of the “suction polypectomy technique,” previously described for the removal of less than 1 cm sessile polyps, for use in cold snare polypectomy of sessile polyps greater than 1 cm. Case Description/Methods: Technique: Olympus high definition colonoscopes (CF-HQ190L/I) were used to identify sessile polyps between 10-15 mm (Table). The snare was passed though the instrument and pulled back slightly into the channel. Polyps were then suctioned using the tip of endoscope for 1-2 seconds. This technique was repeated over the surface of the entire lesion until the polyps puckered up, developing a more polypoid shape. The polyps were then immediately resected via cold snare polypectomy (Figure). All polyps were completely resected and there were no procedural complications. Discussion: This series shows that the “suction polypectomy” technique using a cold snare for polyps 1 cm or greater is feasible and safe with the benefits of not requiring the use of lifting agents, injection needles, or significant technical expertise. Future studies are required to determine the feasibility of suction polypectomy in lesions greater than 1.5 cm and the safety and efficacy of the technique in larger prospective cohorts.Figure 1.: Endoscopic images of the technique. Images labeled “A” show the polyp before suction. Images labeled “B” show the polyp after suction. Images labeled “C” show post-polypectomy. Table 1. - Characteristics of Polyps Removed Patient # Polyp Size Location Pathology Diagnosis En Bloc versus Piecemeal Complications (Immediate/Delayed Bleeding or Perforation) 1 10 mm Descending Colon Tubular Adenoma in Fragments En Bloc None 2 10 mm Ascending Colon Sessile Serrated Adenoma En Bloc None 3 12 mm Ascending Colon Sessile Serrated Adenoma En Bloc None 4 12 mm Ascending Colon Tubular Adenoma in Fragments En Bloc None 5 11 mm Transverse Colon Tubular Adenoma En Bloc None

Colorectal cold snare polypectomy: Current standard technique and future perspectives.

It has been shown that resection of adenomatous colorectal polyps can reduce mortality due to colorectal cancer. In daily clinical practice, simpler and safer methods of colorectal polypectomy have been sought to enable endoscopists to resect all detected lesions. Among these, cold snare polypectomy (CSP) is widely used in clinical practice because of its advantages in shortening procedure time, reducing delayed bleeding risk, and lowering treatment costs, while maintaining a similar complete resection rate for lesions smaller than 10 mm when compared to conventional hot snare polypectomy. This review introduces the findings of previous studies that investigated the efficacy and safety of the CSP procedure for nonpedunculated polyps smaller than 10 mm, and describes technical points to remember when practicing CSP based on the latest evidence, including using a thin wire snare specifically designed for CSP, and observing the surrounding mucosa of the resection site with chromoendoscopy or image-enhanced endoscopy to ensure that there is no residual lesion. This review also describes the potential of expanding the indication of CSP as a treatment for lesions larger than 10 mm, those with pedunculated morphology, those located near the appendiceal orifice, and for patients under continuous antithrombotic agent therapy. Finally, the perspective on optimal treatments for recurrent lesions after CSP is also discussed, despite the limited related evidence and data.

Low-Cost Forensics Reveal High Rates of Non-lethal Snaring and Shotgun Injuries in Zambia's Large Carnivores

The impact of snaring and human-wildlife conflict (HWC) on large carnivore populations is of growing concern, and yet few empirical data are available. Mortality is the metric most often used, but non-lethal injuries that impact fitness are also important threats. However, because non-lethal injuries to wild carnivores are difficult to detect, they have received little study. Using straightforward forensic examination of the skulls of trophy-hunted lions and leopards from Luangwa Valley (LV) and Greater Kafue Ecosystem (GKE), Zambia, we identified non-lethal injuries consisting of snare damage to teeth and shotgun pellets in skulls. Wire snare entanglement can cause permanent, diagnostic damage to carnivore teeth when individuals bite and pull on the wire. Shotguns are used by poachers, as well as during HWCs to drive off carnivores perceived as threats. Carnivores struck by shotgun pellets can suffer non-lethal, but potentially toxic injuries such as pellets embedded in their skulls. Because poaching and HWC are generally more prevalent near human settlements, we predicted a higher incidence of anthropogenic injuries to carnivores in Luangwa where the human population is larger and more concentrated along protected area edges than Kafue. Contrary to expectation, anthropogenic injuries were more prevalent among lions and leopards in Kafue than Luangwa. Notably, definitive evidence of snare entanglement greatly surpassed previous estimates for these regions. Overall, 37% (41 in 112) of adult male lions (29% in Luangwa, 45% in Kafue) and 22% (10 in 45) of adult male leopards (17% in Luangwa, 26% in Kafue) examined had survived being snared at some point in their lifetime. Among adult male lions, 27% (30 in 112) had old shotgun pellet injuries to their skulls. Our procedure of forensic examination of carnivore skulls and teeth, some of which can be applied to live-captured animals, allows for improved detection of cryptic, non-lethal anthropogenic injuries. Further, our methods represent a consistent and economical way to track changes in the frequency of such injuries over time and between regions, thereby providing a direct measure of the effectiveness of conservation programs that seek to reduce poaching and HWC.

A Randomized Controlled Trial of Cold Snare Polypectomy Technique: Technique Matters More Than Snare Wire Diameter.

Cold snare polypectomy (CSP) is safe and effective for the removal of small adenomas (≤10 mm); however, reported incomplete resection rates (IRRs) vary. The optimal CSP technique, where a wide margin of normal tissue is resected around the target lesion, and snare design have both been hypothesized to reduce the IRR after CSP. We sought to investigate the efficacy of a thin-wire versus thick-wire diameter snare on IRR, using the standardized CSP technique. This was an international multicenter parallel design randomized trial with 17 endoscopists of varying experience (NCT02581254). Patients were randomized in a 1:1 ratio to the use of a thin-wire (0.30 mm) or thick-wire (0.47 mm) snare for CSP of small (≤10 mm) colorectal polyps. The primary end point was the IRR as determined by the histologic assessment of the defect margin after polypectomy. Over 52 months to January 2020, 1,393 patients were eligible. A total of 660 patients with polyps (57.4% male) were randomized to a thin-wire (n = 339) or thick-wire (n = 321) snare. The overall IRR of the cohort was 1.5%. There was no significant difference in the IRR between the thin- and thick-wire arms; relative risk-0.41, 95% CI (0.11-1.56), P = 0.21. No significant differences were observed in the rate of adverse events. In this multicenter randomized trial, CSP is safe and effective with very low rates of incomplete resection independent of the diameter of the snare wire used. This suggests that the optimal operator technique is more important than the snare design alone in minimizing residual adenoma after CSP.

How to Manage the Large Nonpedunculated Colorectal Polyp

How to Manage the Large Nonpedunculated Colorectal Polyp