Options for diagnosis and treatment of gastrointestinal diseases: recent advances in technology

Dr. Montero said that the study focuses on a single training institute and a unique and complex laparoscopic procedures, although the same surgeons at Carolinas Medical Center have reached similar conclusions when analyzing other complex laparoscopic procedures such bowel resection and paraesophageal repair, but the discovery of the results as safe for the academic year later than the first, can not be applied to any complicated surgeries or any surgery training centers.‘This gives a new insight into the nature of inflammatory bowel disease, and over time we can identify the disease at an earlier stage, more curable,’ said researcher Ramesh P. Arasaradnam, MD, consultant in gastroenterology and professor at the University of Warwick, England.’ He added that the results of tests may be able to help doctors choose the most appropriate treatment.

Barrett’s esophagus , a condition that can lead to the esophagus, can often be eliminated by radiofrequency ablation and the majority of patients are free for five years after the initial procedure, a new study from the Mayo Clinic . These results may lead to changes in current recommendations of the constant surveillance of BE progression of esophageal cancer. About one in 200 patients with the earliest form of Barrett’s esophagus develop cancer each year, one of the fastest growing cancers.

Development of a stomach wall using artificial bioresorbable polymers

The gut in health and disease: the difference in detection of ‘electronic nose’

Dr. Fleischer and his colleagues will continue to monitor patients to assess the sustainability of the criminal process. He warned that no treatment is perfect, but the technology is exciting and encouraging results to date.

The researchers observed a 80 % rate of success in patients, and a successful 95 % of patients analyzed. Sixty-eight patients with complete resection had a follow-up, 57 were normal controls and 36 months were considered cured, three had incomplete follow-up, asymptomatic, without control, five died of other diseases, three had a recurrence of the tumor 12 and 24 months.

Removal of large tumors of the colon and rectum conventional endoscopic resection is difficult, if typical of these tumors were removed in fragments by this method and patients were colorectomy. Endoscopic submucosal dissection is a promising new therapy that can remove large tumors endoscopically in one piece. To ensure an accurate histological evaluation and removal of any residual tumor, tumor removal in one piece is better to remove them piecemeal.

Dr. Fleischer said there are some limitations in the surveillance of patients with Barrett. Furthermore, the recommendations suggest that the endoscopist takes the number of biopsies and information suggest that the number of biopsies is not always taken.

Ampullectomy: long-term results of a multicenter prospective Grande

Dr. Ponchon ampullectomy warned that difficult endoscopic procedure to be performed by experienced endoscopists. In addition, it should not be made for invasive adenocarcinoma of the bulb, such as endoscopy may be incomplete.

In this prospective, multicenter conducted from May 2004 to November 2009, the researchers conducted endoscopic RFA, designed to burn the abnormal cells of patients with intestinal metaplasia of Barrett. For patients with AD BE 50 was eliminated in the second half and an assessment of the endoscopy was performed at five years. The results showed that 46 of the 50 remained free of BE, and four patients had low levels of residual disease that was cleared in one session RFA.

‘We have demonstrated that treating patients with early Barrett, we were able to eliminate the disease in most cases, and, hopefully, lead to a reduction of cancer associated with it,’ said David Fleischer, MD, Mayo Clinic Arizona staff. ‘RFA is a durable, long-term approach for the treatment of Barrett’s esophagus and restore cells to normal.’

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All subjects survived the trial period without drops of liquid or food. A four to eight weeks after implantation, the implantation site showed a reduction of the patch daily. At 12 weeks, the site of implantation was almost indistinguishable from the original wall of the stomach, apparently. Closer examination confirmed the growth of the mucosa and submucosa, two of the innermost layer of the gastric wall, and a muscle layer similar to the original wall. Subtle differences between the original and artificial wall was confirmed in the connective tissue, including the amounts a little ‘low elastic and smooth muscle density relative to the wall of the stomach of origin

Although ESD is less invasive than colorectomy, a procedure is technically difficult, has a higher incidence of complications and requires a longer time than the conventional operation of the DME. Yoji Takeuchi, MD, Department of Gastrointestinal Oncology Osaka Medical Center for cancer and cardiovascular disease have sought to determine if the flushknife could reduce the operating time without increasing side effects. He also wanted to know if the device could reduce the difficulty of the procedure of ESD, which makes it more accessible to patients.

The endoscopic radiofrequency ablation for Barrett’s esophagus: five-year results of a multicenter prospective sustainability

The researchers, including Thierry Ponchon, MD, professor of medicine at the Centre Hospitalier Universitaire de Lyon, conducted a multicenter prospective study in 93 consecutive patients endoscopic ampullectomy from September 2003 to January 2006. Patients were included in the study if they had positive biopsies , and not ampullectomy or previous laser treatment. Ampullectomy endoscopy were performed by experienced endoscopists using a side-viewing endoscope 11 under sedation. If the pathological examination of the resected area was different from the initial biopsy, a second look was performed by an expert pathologist

Transvaginal cholecystectomy using a series of hybrid NOTES Novel flexible internal retraction system

‘The flushknife is clearly a tool to be used than in the performance of electrostatic discharge,’ said Takeuchi. ‘However, ESD continues to be a very difficult procedure that is not all endoscopist can perform. Further developments are needed for colorectal ESD to become the standard procedure for the removal of large colorectal cancer.’

Comparing the results of ablation of the tumor in the dissection of colorectal endoscopic submucosal large with flexknife flushknife report, researchers from Osaka Medical Center for cancer and cardiovascular disease in Japan have discovered that flushknife, an endoscopic device according to a fountain, is one more tool to remove large colorectal tumors in one piece.

Researchers have developed an efficient and easily and allows them to detect the existence of inflammatory bowel disease using an ‘electronic nose’. It differs from ulcerative colitis, which in turn from normal subjects. The device recognizes the characteristic signature of the bio-smelling conditions.

‘The study demonstrates that the learning model is a degree of responsibility in surgery can lead to operating safely and effectively, providing high quality training,’ said Dr. Montero. ‘In an era of technological advances, the potential shortage of surgeons and work hour restrictions, this result is very important that we continue to train the surgeons again.’

The researchers sought to examine the results and effectiveness of the procedures adopted in a bag, including the duration of the operation, the amount of bleeding, complications and length of hospital stay, to determine whether significant differences between the months of training beginning and after. They analyzed the results of the first and late , school year and found periods of time to be the safest. The so-called ‘July effect’ was studied in institutions of medical education in surgery and general medicine, but in terms of perfecting surgical approaches with new and more complex, it was described above.

To determine the effectiveness of the procedure, patients were followed 4-8 weeks, further resection if necessary. Patients were followed for six, 12, 18, 24 and 36 months with systematic biopsies. The procedure was considered curative if the resection was complete, no cancer was observed submucosa, cancer control was normal in six months and no relapses were observed during the monitoring period.

A new study from the Carolinas Laparoscopic and Advanced Surgery Program Carolinas Medical Center in Charlotte, North Carolina, found that the performance of advanced laparoscopic procedures in a program of minimally invasive surgery is safe, regardless of whether the surgery is done in advance or late for training grants.

A new study of the French Society of Digestive Endoscopy demonstrates the long-term efficacy of endoscopic ampullectomy for the treatment of ampullary adenomas, early cancers of the small muscle located at the confluence of the bile duct in the small intestine. Ampullectomy endoscopy was found to be more precise as surgery and resulted in fewer side effects and lower morbidity of the patient.

‘Currently, we are limited by some of our equipment. We need tools specifically designed to continue to move forward in this area,’ said Eric S. Hungness, MD, FACS, Associate Professor of Surgery, Feinberg School of Medicine at Northwestern University. ‘The optimal design of equipment can lead to more efficiency and greater safety, less pain, better recovery and the surgery less invasive for patients

Researchers at Saitama Medical University Saitama, Japan, have developed a revolutionary material that can repair and regenerate the stomach wall without distorting the stomach or stop the gastrointestinal tract. The material, a bioabsorbable polymer implant patch has been shown to maintain normal function after gastrointestinal surgery GI in animal models.

Dr. Takeuchi and his colleagues recruited 49 patients with colorectal cancer in their study superficial and were randomly assigned to undergo ESD using flushknife or flexknife . They found that the flushknife allowed them to wash the mucus and blood clots and to inject saline into the submucosa during the procedure, which is an important step to prevent perforation of the colon during ESD.

The researchers examined all operational data and post-operative Scholarship Program identified during the months when a man was involved in a complex – in this case Heller myotomy by laparoscopy – and if a certain time has been associated with poorer outcomes. This surgery involves dissection relatively rare delicacy of certain levels of the esophagus in a less commonly encountered in general surgery . In this study period, 54 cases were completed within the allotted time.

Natural orifice transluminal endoscopic surgery is a surgical technique performed through an endoscope through a natural orifice or opening in the body. NOTES reduces the need for incisions and can afford less pain and scarring associated with traditional laparoscopic surgery with a recovery time much faster for the patient. In recent years, NOTE has been expanded to include more procedures, but the most advanced surgical instruments are needed to improve the effectiveness and safety of these procedures.

These results contradict previous research suggesting that medical care at the beginning of the academic year may carry more risk than other times. Because some surgical techniques for advanced laparoscopic procedures not taught in general surgery residence and additional training is needed, one might think that the results of surgery may be worse during the first months of ‘academic year new students arrive.

The researchers plan to study the gastric function and the preservation of the shape of the organ patches with BAP for a period of time longer. They also plan to study the use of the patch in the small intestine and large intestine.

Endoscopic radiofrequency ablation is an effective treatment for the elimination of Barrett’s esophagus, an electronic ‘nose’ provides a quick and effective in detecting inflammatory bowel disease, artificial replacements were developed to replace the gastrointestinal tissue is removed, and the researchers ampullectomy found that endoscopic treatment of ampullary adenomas for is more accurate than surgery with fewer side effects. These are among the studies presented at Digestive Disease Week 2010. DDW is the largest international gathering of physicians and researchers in the field of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

Miyazawa has warned that even if these results are promising, treatment has yet to be tested on humans in a clinical study in a cooperative global.

Surgeries are currently available to remove the abnormal growth of tissue of the stomach are very effective, but involve a partial removal of the part , stomach, leaving the stomach twisted and / or reduction of gastrointestinal function. Researchers have developed a patch to serve as BAP implantable artificial gastric wall to allow removal of a defect in stomach tissue without compromising the function or biology of the organ. The patch consists of a copolymer of polylactic acid and BAP 50:50 fiber reinforced polycaprolactone glycolic acid and designed to degrade in about 6-8 weeks after implantation.