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Endoscopy in surgical practice.pptx
- 1. ENDOSCOPY IN SURGICAL PRACTICE: THE FUTURE OF SURGERY DR. JYOTI RANJAN MOHAPATRA ASSISTANT PROFESSOR DEPT. OF SURGERY, SJMCH
- 2. SPECIAL THANKS … •PROF. DR. MANOJ KUMAR SETHY . HOD .DEPT OF SURGERY
- 3. I HAVE NOCONFLICT OF INTEREST • PERVIEW OF DISCUSSION : GASTROINTESTINAL ENDOSCOPY
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- 5. ADOLF KUSSMAL :GERMAN PHYSICIAN TRIED INSERTING CAMERA BUT NO ILLUMINATION …..STILL ON CANDLES &LAMPS
- 6. PEEK INTO THEHISTORY…….
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- 12. ADVANCEMENT IN IMAGINGTECHNOLOGY • CCD : CHARGED COUPLED DEVICES • VIDEOGRAPHY • RESOLUTION
- 14. • First fiberopticendoscope by Basil Hirschowitz in 1958.
- 15. Basil Hirscowitz doingendoscopy
- 16. HISTORICAL LANDMARKS INGI ENDOSCOPY • 1968-Endoscopic Retrograde pancreatography • 1969-Colonoscopic polypectomy • 1970-Endoscopic Retrograde cholangiography • 1974-Endoscopic Sphincterotomy • 1979-Percutaneous Endoscopic Gastrostomy • 1980-Endoscopic Injection Sclerothrapy • 1980-Endoscopic ultrasound • 1985-Endoscopic control of Upper GI bleeding • 1990-Endoscopic Variceal Ligation
- 17. BACKGROUND • last 2decades have witnessed significant advances in luminal endoscopy. • Initially as a diagnostic tool therapeutic purposes. • Conventional Surgeries Laparoscopy Scarless /endoscopic Sx. • Technical advancement in radiology and image enhancement changed the dimensions of future surgical world LEAST INVASIVE SURGERY
- 19. WHAT IS ENDOSCOPY??? • Endoscopy Greek Word “Endo”means “Inside” “Skopeein ”means “To See” • • Examination of the interior of a canal or hollow viscus
- 20. DIRECT VIEWING OF INTERIOROF ORGAN determine the cause of a problem Establish the diagnosis
- 23. SCOPE OF ENDOSCOPY Diagnostic / Therapeutic Conventional /Modern Recent experimental advances
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- 25. DIAGNOSTIC • aim ofthe procedure :- purely to visualize a part of the gastrointestinal, respiratory or urinary tract in order to aid diagnosis • flexible optical fiber endoscopy • use of optical spectroscopy • CCD/CMOS video cameras and improved optical fibers • use of endoscopic optical biopsy. • invention of the pill “camera” (PillCam®)
- 26. • GI lesionseg, GI malignancies, ulcers, erosions, ectasias,varices, • Incontinence • Abnormal anatomy(dilatations, strictures, diverticulum, deformities • Hernias • GI bleeding, • Foreign body exploration • Follow up & surveillance of malignancies • Screening of the high risk groups • Staging of the diseases (endoscopic ultrasound)
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- 37. USE OF CHROMOENDOSCOPY •Procedure that uses stains . Pigments or dyes to locate abnormality in the mucosal lining of the organs • Enhance the characterisation of the tissues • Stains : absorptive contrast reactive • NARROW BAND IMAGING : ambient light of a blue and green wavelengths are used to highlight detail, particularly of vascular strutures
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- 40. CONFOCAL ENDOMICROSCOPY • Confocallaser endomicroscopy (CLE) • developed to obtain very high magnification of the mucosal layer of the gastrointestinal (GI) tract • histological diagnosis in real time • reducing unnecessary resections, avoiding repeated biopsies and unnecessary follow-up, and indirectly decreasing the risks and costs
- 43. ENDOSCOPIC ULTRASOUND (EUS) • ENDOSCOPY COMBINED WITH ULTRASOUND • OBTAIN IMAGES OF THE ORGANS WITH BETTER CLARITY • SCREENING OF THE CANCERS (EG. PANCREAS,ESOPHAGUS, STOMACH ,RECTUM ) • OBTAIN ULTRASOUND GUIDED BIOPSY WITH BETTER ACCURACY • ASSESS THE ANAL SPHINCTER INTEGRITY
- 45. THERAPEUTIC • endoscopic procedureduring which treatment is carried out via the endoscope. • a procedure which starts as a diagnostic endoscopy may become a therapeutic endoscopy depending on the findings.
- 46. Eg. • Endoscopic haemostasis •Injection sclerotherapy • Argon plasma coagulation • Dilatation • Polypectomy • Variceal banding • Stenting • Percutaneous endoscopic gastrostomy • Foreign body removal
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- 57. CONVENTIONAL ENDOSCOPY • UPPERGI • LOWER GI (SIGMOIDOSCOPY, COLONOSCOPY ) • CAPSULE ENDOSCOPY
- 58. MODERN ENDOSCOPY • ERCP •EUS • MOTHER BABY CHOLANGIOSCOPES
- 59. ERCP • TECHNIQUE THATCOMBINES THE USE OF ENDOSCOPY AND FLUROSCOPY TO DIAGNOSE AND TREAT BILIARY AND PANCREATIC DUCTAL PATHOLOGIES • GALLSTONES, STRICTURES ,LEAKS (TRAUMA & SURGERY), CANCER • NOW PERFORMED ONLY WITH THERAPEUTIC INTENT
- 61. MOTHER BABY ANDSPYGLASS CHOLANGIOSCOPES
- 62. REAL TIME SPYGLASS CHOLANGIOSCOPY
- 63. SCOPE OF ENDOSCOPY Diagnostic / Therapeutic Conventional /Modern Recent advances
- 64. RECENT ADVANCES …. •SECOND SPACE ENDOSCOPY : NOTES • THIRD SPACE ENDOSCOPY : POEM , POP , STER • FOURTH SPACE ENDOSCOPY: SUBSEROSAL DISSECTION (ESSD) • COLONOSCOPIC APPENDIDECTOMY
- 65. THORNS IN THEBED OF ROSES…. COMPLICATIONS • BLEEDING • PERFORATION • GAS EMBOLISM • INTRODUCTION OF INFECTION • PERITONITIS