Inflammatory Myoglandular Polyp of the Right Colon in a Patient with Hematochezia and Intermittent Rectal Pain.
INTRODUCTION: Inflammatory Myoglandular Polyps (IMP's) are poorly characterized and extremely rare. They present most frequently in the left colon, and may produce symptoms related to this location. We present a case of IMP located in the right colon, associated with rectal symptoms, and offer a review of the available medical literature. CASE REPORT: A 35… Continue Reading
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Accessing the Gastric Remnant After Roux-en-Y Gastric Bypass
INTRODUCTION: A minimally invasive method for accessing the gastric remnant to intervene on the biliary and pancreatic system after Roux-en-Y gastric bypass (RYGB) has not been well described. This is a retrospective review describing two surgeons’ complete experience with laparoscopic trans-gastric (LaTG) ERCP for biliary and pancreatic duct management.METHODS AND PROCEDURES: Twelve patients underwent LaTG-ERCP.… Continue Reading
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Prospective Monitoring of Surgical Trainee Endoscopy Volumes
Introduction: Despite a recent increase in endoscopic surgery requirements for graduate surgical trainees by the Residency Review Committee for Surgery (RRC-S), there is still a question of competence: is the endoscopic volume achieved by surgical trainees sufficient for the procedural competence needed by practicing surgeons in academic centers and community hospitals? Prospective monitoring of trainee… Continue Reading
Esophageal Dilatation for Corrosive Stricture of the Esophagus
Less was known regarding outcome of dilatation in corrosive stricture of the esophagus. The aim of this study was to report the treatment outcome of dilatation for corrosive esophageal stricture.Methods: Medical records of twenty-three patients with corrosive esophageal stricture who underwent esophagal dilatations were reviewed. All dilatations were performed under general anesthesia using Savary-Gillard dilator… Continue Reading
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Endoscopic Ultrasound-guided Gastrostomy After Roux-en-Y Gastric Bypass: A Novel Approach
Objective: Gastrostomy tube (GT) placement after Roux-en-Y gastric bypass can be challenging. Novel, minimally invasive approaches are needed to access the gastric remnant in these patients. Our objective is to present an innovative method of endoscopic ultrasound (EUS)-guided GT placement.Procedure Description: A 55 year-old morbidly obese female underwent reoperative, open retrocolic Roux-en-Y gastric bypass, and… Continue Reading
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Endoscopic and Manometric Characteristics of the Gastroesophageal Valve in Lateral Decubitus and Upright Positions in Clinically Normal Patients
Background: The relationship between body position and the gastroesophageal junction (GEJ) has been subject to intense interest in its role in gastroesophageal reflux disease (GERD). Few studies have looked at the position related changes of the gastroesophageal valve (GEV) in asymptomatic individuals.Purpose: To define the normal physiology of the GEJ in left lateral decubitus (LLD)… Continue Reading
Single Incision Experience At San Diego: The Evolution of Clear Imaging
Objective: Classic laparoscopic surgery is based on the ability to triangulate instrumentation to have good exposure and working space. This is done with multiple trans-abdominal ports. Decreasing the number of ports may be beneficial in decreasing pain. In addition elimination of port sites eliminates the risk of herniation at those sites and provides a definite… Continue Reading
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Dilation of Anastomotic Strictures After Transhiatal Esophagectomies
Objective: Anastomotic stricture presenting with dysphagia after transhiatal esophagectomy is a common problem. We have reviewed our experience with esophageal dilatations after transhiatal esophagectomies. Methods: We retrospectively reviewed the medical records of all patients who underwent esophageal dilatation after transhiatal esophagectomies. Demographic data, number and methods of dilatations, time between dilatations, and time between surgery… Continue Reading
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Endoscopic Tissue Fusion for Weight Regain After Gastric Bypass: Does It Help?
Background: Gastric bypass results in significant weight loss in the morbidly obese population. There is however, an incidence of weight regain associated with the procedure. One theory for the weight regain is pouch dilation. StomaphyX is a device which addresses pouch dilation by endoscopically plicating the gastric pouch, resulting in a decreased pouch size. This… Continue Reading
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Single Incision Laparoscopic Cholecystectomy
Introduction: Single incision laparoscopic surgery (SILS) has been proposed as a minimally invasive technique with proposed advantages of smaller external scars and reduced pain. Furthermore, usage of the flexible endoscope for SILS in lieu of the standard laparoscope provides distinct visualization advantages. This video illustrates a single incision cholecystectomy performed through a single incision placed… Continue Reading
Single Site Series Utilizing the Endosurgical Operating System (eos) for Revision of Post Roux-en-Y Gastric Bypass Stomal and Pouch Dilitation
SINGLE SITE SERIES UTILIZING THE ENDOSURGICAL OPERATING SYSTEM (EOS) FOR REVISION OF POST ROUX-EN-Y GASTRIC BYPASS STOMAL AND POUCH DILITATION. Michael Chaump, M.D., Roy M. Dressner, D.O., Steven A. Gorcey, M.D., Frank J. Borao, M.D., Monmouth Medical Center, Long Branch NJIntroduction: Interventional therapy for weight regain after Roux-en-Y gastric bypass surgery (RYGB) has been tempered… Continue Reading
40th Anniversary of the First Endoscopic Retrograde Pancreatogram
2008 marks the 40th anniversary of endoscopic retrograde cholangiopancreatography (ERCP). In 1968, a group of physicians from the George Washington University Medical Center published the first report that documented the initial clinical application of ERCP.The successful procedure was performed by Drs. McCune, Shorb, and Moscovitz and was predicated on hours of canine research followed by… Continue Reading
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Laparoscopic Common Bile Duct Exploration and Laser Lithotripsy: A Novel Approach to Management of Common Bile Duct Stones
Introduction: Common bile duct stones (CBDS) are found in approximately 10% of patients who undergo cholecystectomy. Symptomatic common bile duct stones are a source of significant morbidity as they may cause obstructive jaundice, cholangitis, biliary cirrhosis and pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) has been a mainstay of treatment for common bile duct stones. Laparoscopic common… Continue Reading
Treatment of Ultra-long Segment Barretts Using Focal and Balloon-based Radiofrequency Ablation
INTRODUCTION: Endoscopic radiofrequency ablation (ERFA) is being evaluated as definitive treatment for patients with Barrett’s esophagus (BE). Guidelines have yet to be developed for the application of this technology to patients with ultra-long segment BE (ULBE, > or = to 8cm). This study reports a single institution’s experience with ERFA of ULBE with various degrees… Continue Reading