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Journey by flexible endoscopy
This document describes the journey of flexible endoscopy at the Department of Surgery of Dhaka Medical College & Hospital in Bangladesh. It discusses the history of endoscopy and lists mentors who supported the development of their endoscopy suite. The suite is described along with equipment. The document focuses on their experience with colonoscopy, providing details on patient preparation, sedation used, and their single-handed painless technique without air insufflation. Outcomes of their first 720 colonoscopy cases are presented along with therapeutic procedures performed. Their efforts to train residents and conduct workshops on laparoscopic and endoscopic skills are also summarized.
Journey by flexible endoscopy
- 1. A JOURNEY BY FLEXIBLE ENDOSCOPY DR.MASFIQUEAHMED BHUIYAN MBBS(DMC) FCPS(SURGERY) LAPARO-ENDOSCOPIC SURGEON DEPARTMENT OF SURGERY DHAKA MEDICAL COLLEGE & HOSPITAL.
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- 6. IN 2013 WE,DEPARTMENTOF SURGERY STARTED OUR JOURNEY
- 7. LAPAROSCOPY CAN NOTBE COMPLETED WITHOUT FLEXIBLE ENDOSCOPY
- 8. GREATFULL TO THESEGREAT MENTORS •PROF. M A HASHEM BHUIYA •PROF. A Z M MOSTAQUE HOSSAIN TUHIN •PROF. A B M KHURSHID ALAM •PROF. A H M TOWHIDUL ALAM •PROF. AHMEDUL KABIR •PROF.ABDUL HANIF TABLU •PROF.K ABUL KALAM AZAD •PROF . FAROQUE AHMED
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- 12. ENDOSCOPY SUITE (cont…..)Diathermy
- 13. ENDOSCOPY SUITE (cont…..)PROCESSOR
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- 15. ENDOSCOPY SUITE (cont…..) LAPARO-ENDOSCOPICUNIT DHAKA MEDICAL COLLEGE HOSPITAL BANGLADESH
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- 20. • WE WILLSHARE OUR COLONOSCOPIC EXPERIENCE
- 21. Indications of colonoscopy: • Surveillance in persons with average and high risk for colon cancer • Faecal occult blood • Iron deficiency anaemia • Haematochezia • Malaena with nondiagnostic UGI endoscopy • After finding colonic polyps on sigmoidoscopy • Adenocarcinoma metastasis to liver with unknown primary • Follow up after colonoscopic removal of large sessile colonic polyp • Abnormal radiographic study ( contrast enema, virtual colonoscopy) • Colonic stricture • Intraoperative colonoscopy to localise lesion for surgical removal
- 22. Patient source • InPatient Department. • Out Patient Department.
- 23. Patient preparation • Adequatecounseling. • Valid informed written consent. • Dietary modification. • PEG sol • USUAL AS BOWEL PREPARATION IN BOWEL SURGERY.
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- 25. HOW WE DID •PAINLESS NON LOOP CAP COLONOSCOPY • COLONOSCOPY WITHOUT AIR THAT MEANS LESS DISCOMFORT • SINGLE HANDED TECHNIQUE
- 26. LIMITATION OF COLONOSCOPY PROCEDURE •SEVERE PAIN EXPERIENCE DURING THE PROCEDURE • GENERAL ANAESTHESIA • LESS NUMNER OF EXPERTIES IN FLEXIBLE ENDOSCOPY • SURGEONS ARE RELACTANT TO DO COLONOSCOPY
- 27. CONVENTIONAL COLONOSCOPY • DIFFICULT •PAINFULL FOR THE PATIENT • NEED ASSISTANT • LONG LEARNING CURVE • CAECAL INTUBATION RATE IS LESS • MORE CHANCE OF PERFORATION • FAILURE RATE IS HIGH
- 28. OUR MISSION • DEVELOPEDA SPECIAL TECHNIQUE OF COLONOSCOPY • WHICH IS PAINLESS • NO AIR NO DISCOMFORT • WE USE WATER • WE USE DISTAL ATTATCHMENT CAP • MERGE ENDOSCOPY WITH LAPAROSCOPY
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- 30. HOW TO HOLDTHE SCOPE WITH LEFT HAND
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- 34. WE ADOPTED TOMOAKIKARUBE FROM JAPAN TECHNIQUE
- 35. • I WITHTOMOAKI KARUBE TRANSLATE THIS BOOK IN ENGLISH AND IT WILL BE AVAILABLE SOON BY INTERNATIONAL PUBLISHER. • THIS IS ACTUALLY DESCRIPTION OF PAINLESS NON LOOP TECHNIQUE OF COLONOSCOPY. • ONE OF THE BEST BOOK OF COLONOSCOPY TECHNIQUE IN JAPANEESE LANGUAGE AND ALREADY PUBLISHED BY JAPANEESE MEDICAL JOURNAL.
- 36. WHAT WE DID Totalnumber of procedure 720 Screening 20 Diagnostic 672 Therapeutic 28
- 37. SCREENING TOTAL NUMBER 20 NORMALFINDING 18 ABNORMAL FINDING 2
- 38. DIAGONOSTIC TOTAL NUMBER 672 FINDINGMALIGNANCY ILEOCAECAL TB CROHN’S ULCERATIVE COLITIS
- 39. NORMAL RECTUM FROMINSIDE
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- 47. THEREPEUTIC IN THISSUITE • VOLVULUS DEFLATION 10 • POLYPECTOMY 16 • EMR 2
- 48. COLOSCOPIC VOLVULUS DEFLATION DEFLATION Mr.Ali Haydar, 65 yrs old male admitted in emergency with sigmoid volvulus
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- 51. PICTURE OF HYBRIDTECHNIQUE
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- 53. Flat broad basepolyp which can not be removed by conventional snaring
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- 57. CONTINUED TRAINING PROGRAME ENDOSCOPYWITH LAPAROSCOPY
- 58. HANDS ON WORKSHOPORGANIZED BY DEPARTMENT OF SURGERY IN COLABORATION WITH 4 SOCIETIES:
- 59. HANDS ON WORKSHOPat KORMOCHARI HOSP
- 60. CODUCTING BASIC LAPARO-ENDOSCOPIC TRAININGFOR RESIDENTS
- 61. Opening of newhorizons to the Surgical Trainees:
- 62. THANKS FOR PATIENCEHEARING we know we have limitation but we have the courage to overcome it.