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01.04.2016 - Шабат.ppt

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Ендоскопічні методи лікування «раннього» раку шлунку та стравоходу Шабат Галина, к. мед. н, хірург, Ендоскопічні методи лікування «раннього» раку шлунку та стравоходу Шабат Галина, к. мед. н, хірург, ендоскопіст Національний інститут раку 01. 04. 2016 – Онкошкола - НІР

Paris Classification Kudo’s (pit pattern) Classification Paris Classification Kudo’s (pit pattern) Classification

Background • • 1968 – Niwa – polypectomy technique 1984 – Tada et al. Background • • 1968 – Niwa – polypectomy technique 1984 – Tada et al. – EMR (strip biopsy method) 1988 – Hirano et al. – EMR (with injection. . ) 2005 – Muto et al. , 2006 – Oka et al. – ESD • Position change and fluid injection, gravity Sumivoshi et al. , 2002

Olympus cap • Single-use distal attachments • Reusable distal attachments (Yamamoto et al. 2003) Olympus cap • Single-use distal attachments • Reusable distal attachments (Yamamoto et al. 2003) (Fujifilm. Tokyo, Japan)

Irrigation cap (Type KUME) Coagula-irrigation hood (CI hood) Endoscopic fan device A: Blowing type; Irrigation cap (Type KUME) Coagula-irrigation hood (CI hood) Endoscopic fan device A: Blowing type; B: Ventilation type

Irrigation hood knife. A: Photo; B: Schematic representation of ESD using the hood-knife. Cap-knife Irrigation hood knife. A: Photo; B: Schematic representation of ESD using the hood-knife. Cap-knife attachment (Type KUME) with a fixed snare placed on the tip of the endoscope through grasping forceps The irrigation wiper-knife. A: Photo; B: Schema of a needle-knife moving like a windshield wiper (both ends red arrow); C: Schematic representation of the ESD using the wiper-knife.

• Endoscopic esophageal mucosal resection tube • Endoscopic esophageal mucosal resection tube

+ Vibration Endoscope + Vibration Endoscope

Multi-camera system using 1 -channel camera-hood A: Placed at the tip of the endoscope Multi-camera system using 1 -channel camera-hood A: Placed at the tip of the endoscope B: Schema of the 1 -channel camera-hood (B) C: Schematic representation of EMR

Endo Lifter (La-201, 202. Olympus, Tokyo, Japan) Endo Lifter (La-201, 202. Olympus, Tokyo, Japan)

Clip-with-line method Lee et al. Clip-with-line method Lee et al.

Clip-with-line method Oyama et al. Clip-with-line method Oyama et al.

Clip-with-line method Jeon et al. Clip-with-line method Jeon et al.

Clip-with-line method Ota et al. Schema: The 1 clip with the line can be Clip-with-line method Ota et al. Schema: The 1 clip with the line can be pulled to the anal side with the 2 -nd clip, which is fixed at the opposite side.

Clip-with-line method Li et al. The distal loop is anchored on the edge of Clip-with-line method Li et al. The distal loop is anchored on the edge of the resection mucosa with the first clip. The pulley loop is fixed on the opposite of the gastric mucosa with the second clip.

Clip-and-snare method with a pre-looping technique during gastric endoscopic submucosal dissection - Naohiro Clip-and-snare method with a pre-looping technique during gastric endoscopic submucosal dissection - Naohiro Yoshida transparent cap lesion is grasped in retroflexion with the hemoclip. This technique is difficult and risks gastric tissue injury, especially when lesions are located in the upper body

TT(thread-traction)-method Yoshiki Koike et al. TT(thread-traction)-method Yoshiki Koike et al.

Percutaneous-traction method Kondo et al. A small snare is introduced into the gastric lumen Percutaneous-traction method Kondo et al. A small snare is introduced into the gastric lumen through a gastric port to grasp and pull the lesions.

Percutaneous-traction method Delius et al. Percutaneous-traction method Delius et al.

Percutaneous-traction method Chen et al. • methods using a looped insertion wire for the Percutaneous-traction method Chen et al. • methods using a looped insertion wire for the esophageal lesions. • The loop end of the wire inserted through the PEG route grasped using biopsy forceps and pulled into the esophagus. • The wire fixed on the proximal edge of the resected mucosa with a clip. • The wire gently pulled out through the PEG route, and the edge of the resected mucosa pulled away from the muscle layer.

Percutaneous-traction method Nishiwaki et al. Percutaneous-traction method Nishiwaki et al.

Magnetic anchor method Kobayashi et al. Magnetic anchor method Kobayashi et al.

Magnetic anchor method Gotoda et al. Magnetic anchor method Gotoda et al.

External forceps method Imaeda et al. External forceps method Imaeda et al.

Internal traction method Parra-Blanco et al. Internal traction method Parra-Blanco et al.

Internal traction method “medical ring” Matsumoto et al. Internal traction method “medical ring” Matsumoto et al.

Internal traction method Sakurazawa et al. One end of the stainless-steel spring device (length Internal traction method Sakurazawa et al. One end of the stainless-steel spring device (length 20 mm) - ftted with a polyurethane loop and the other end is fitted with a clip, which was attached to the opposite side.

Internal traction method Chen et al. Internal traction method Chen et al.

Double-channel-scope method Yonezawa et al. Distal tip of the R-scope with its two deflectable Double-channel-scope method Yonezawa et al. Distal tip of the R-scope with its two deflectable channels in perpendicular planes. Ishigooka et al. , Neuhaus et al. Hijikata et al. – Articulated grasper Hijikata et al. featured in the NOTES toolbox (Ethicon)

Double-channel-scope method Lee et al. • A, clear distal cap attached to the tip Double-channel-scope method Lee et al. • A, clear distal cap attached to the tip of the endoscope (white arrows) to optimize visualization. • B, forceps in the left working channel of the R-scope (white arrow) grasping the lesion to expose the submucosal space for dissection.

Outerroute method Motohashi et al. Outerroute method Motohashi et al.

Outerroute method Okamoto et al. Outerroute method Okamoto et al.

Outerroute method Tsao et al. Outerroute method Tsao et al.

Outerroute method Ohata et al. Outerroute method Ohata et al.

Outerroute method Teoh et al. - Endolifter Outerroute method Teoh et al. - Endolifter

Hirao et al. , Morita et al. – double endoscopes Hirao et al. , Morita et al. – double endoscopes

Double – scope method Higuchi et al. , Ahn et al. Double – scope method Higuchi et al. , Ahn et al.

Robot-assisted method Ho et al. , Wang et al. Robot-assisted method Ho et al. , Wang et al.

Robot-assisted method Phee et al. Robot-assisted method Phee et al.

Suture-pulley method for endolumenal triangulation in endoscopic submucosal dissection - Rieder et al. Suture-pulley method for endolumenal triangulation in endoscopic submucosal dissection - Rieder et al.

Suture-pulley method Hiroyuki Aihara et al. Suture-pulley method Hiroyuki Aihara et al.

Système d'endoscope avec bras pivotants EP 1985226 B 1 “Dallemagne, Marescaux et al. Système d'endoscope avec bras pivotants EP 1985226 B 1 “Dallemagne, Marescaux et al. "

Method and system for transhiatal esophagectomy US 20140163318 A 1 , Lee L. Swanstrom Method and system for transhiatal esophagectomy US 20140163318 A 1 , Lee L. Swanstrom

G-SURG Gmb. H Ovesco Clip G-SURG Gmb. H Ovesco Clip

Balloon-Armed Mechanical Counter Traction and Double-Armed Bar Suturing Systems for Pure Endoscopic FTR Hirohito Balloon-Armed Mechanical Counter Traction and Double-Armed Bar Suturing Systems for Pure Endoscopic FTR Hirohito Mori et al.

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