David Desilets - Academia.edu (original) (raw)

Papers by David Desilets

Research paper thumbnail of The American Society for Gastrointestinal Endoscopy PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) on peroral endoscopic myotomy

Gastrointestinal Endoscopy, 2015

Research paper thumbnail of Case of chronic pancreatic brucellosis presenting as hemosuccus pancreaticus

JOP : Journal of the pancreas, 2007

Hemosuccus pancreaticus is an uncommon cause of upper gastrointestinal bleeding. Chronic infectio... more Hemosuccus pancreaticus is an uncommon cause of upper gastrointestinal bleeding. Chronic infection of the pancreas with Brucellosis causing hemosuccus pancreaticus has not been previously reported. We describe a case of a 75-year-old man presenting with a pancreatic mass and hemosuccus pancreaticus secondary to chronic pancreatic brucellosis. Polymerase chain reaction analysis of the pancreatic tissue was positive for brucella after an initial positive serology. ERCP revealed bleeding from the pancreatic duct. Computed tomography scans of the abdomen demonstrated an enlarging pancreatic mass. Endoscopic ultrasound showed a cystic mass in the body of the pancreas. Fine needle aspiration revealed granulomata. Selective mesenteric angiogram failed to reveal the source of bleeding. The patient eventually underwent pancreatic resection with resolution of symptoms. This is the first case of hemosuccus pancreaticus due to chronic pancreatic brucellosis reported in medical literature.

Research paper thumbnail of Endoscopic Interventions for Weight Loss Surgery

Research paper thumbnail of Measurement of the quality of care of patients admitted with decompensated cirrhosis

Liver International, 2014

Process-based quality measures are increasingly used to evaluate hospital performance. However, p... more Process-based quality measures are increasingly used to evaluate hospital performance. However, practices vary, and patients with cirrhosis are a challenge to manage, given their risks of mortality, morbidity, and resources utilization. In 2010, process-based quality measures were developed to improve the care of these patients. We examined adherence with these quality measures for a cohort of patients admitted with decompensated cirrhosis in 2009. We performed a retrospective analysis of all patients admitted to a tertiary-care hospital with decompensated cirrhosis in 2009 (n = 149,379) hospitalizations. Quality indicator (QI) scores were calculated for each admission as a fraction, i.e., the number of quality markers met divided by the number of possible quality indices, given the patient's presentation (range, 0-1). QI scores were correlated with patient characteristics and clinical outcomes (30-day readmission; inpatient death). Quality indicators were met 45% of the time (95% confidence interval, 40-51%). In multivariable analysis, QI scores were significantly lower among non-English-speaking patients and those who had congestive heart failure. QI scores were higher among patients with gastrointestinal bleeding or encephalopathy-related admission to the hospital. QI scores were not associated with inpatient mortality or 30-day readmission. There is substantial opportunity to improve the care of patients hospitalized for decompensated cirrhosis. Additional research is needed to identify effective strategies for closing gaps in care. Adherence to quality measures did not affect clinical outcomes, but if easily measured in other settings could be used to compare hospitals and practices.

Research paper thumbnail of Brunner Gland Cyst

International Journal of Surgical Pathology, 2007

Research paper thumbnail of GI endoscopes

Gastrointestinal Endoscopy, 2011

The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technolog... more The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the Committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through September 2010 for articles related to endoscopy by using the key words "gastroscope," "colonoscope," "echoendoscope," "duodenoscope," "choledochoscope," "ultraslim endoscope," "variable stiffness colonoscope," and "wide-angle colonoscope." Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard…

Research paper thumbnail of Minimizing occupational hazards in endoscopy: personal protective equipment, radiation safety, and ergonomics

Gastrointestinal Endoscopy, 2010

Research paper thumbnail of Enteral nutrition access devices

Gastrointestinal Endoscopy, 2010

The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technolog... more The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidencebased methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but, in many cases, data from randomized, controlled trials are lacking. In such situations, large case series, preliminary clinical studies, and expert opinions are used.

Research paper thumbnail of Drug-eluting/biodegradable stents

Gastrointestinal Endoscopy, 2011

DISCLOSURE: J. Tokar is a consultant for Boston Scientific and is a speaker for and recipient of ... more DISCLOSURE: J. Tokar is a consultant for Boston Scientific and is a speaker for and recipient of an educational grant from Fujinon. D. Pleskow is a consultant for Boston Scientific and is on the medical advisory board of Beacon Endoscopic. LM Wong Kee ...

Research paper thumbnail of Enteral stents

Gastrointestinal Endoscopy, 2011

The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews ... more The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases, data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through August 2010 for articles related to enteral, esophageal, duodenal, and colonic stents. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment.

Research paper thumbnail of Training in patient monitoring and sedation and analgesia

Gastrointestinal Endoscopy, 2007

Gastrointestinal Endoscopy, Volume 66, Issue 1, Pages 7-10, July 2007, Authors: Prepared by: Trai... more Gastrointestinal Endoscopy, Volume 66, Issue 1, Pages 7-10, July 2007, Authors: Prepared by: Training Committee; John J. Vargo, MD, MPH, FASGE; Asyia S. Ahmad, MD; Harry R. Aslanian, MD; Jonathan M. Buscaglia, MD; Ananya M. Das, MD; David J. Desilets, MD; Brian J. Dunkin ...

Research paper thumbnail of Autofluorescence imaging

Gastrointestinal Endoscopy, 2011

The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews ... more The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of new or emerging endoscopic technologies that have the potential to affect the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent pre-clinical and clinical studies on the topic and a MAUDE (Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but, in many cases, data from randomized controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. For this review, the MEDLINE database was searched through January 2010 by using the keywords "autofluorescence imaging" and "autofluorescence endoscopy".

Research paper thumbnail of Loop-anchor purse-string versus endoscopic clips for gastric closure: a natural orifice transluminal endoscopic surgery comparison study using burst pressures

Gastrointestinal Endoscopy, 2009

Background: The success of natural orifice surgery depends on a reliable, secure closure of the o... more Background: The success of natural orifice surgery depends on a reliable, secure closure of the opening in the gut. Few tests of the integrity of these closures have been published.

Research paper thumbnail of Gastric Transmural Pressure Measurements In Vivo: Implications for Natural Orifice Transluminal Endoscopic Surgery (NOTES®)

Gastrointestinal Endoscopy, 2009

Background and Aims: NOTESÔ is in evolution. Fundamental NOTESÔ techniques and essential tools fo... more Background and Aims: NOTESÔ is in evolution. Fundamental NOTESÔ techniques and essential tools for performing ''no scar'' surgery still need to be developed. Our study was aimed to evaluate the feasibility of combined use of flexible and rigid instruments in performing surgical procedures without scars. Methods: This experimental study was conducted in a laboratory setting with the approval of the IACUC. Segmental small bowel resection was performed using porcine model. 1 non survival and 2 survival experiments were performed to date. A Veress needle was used to create pneumoperitoneum. The anterior colonic wall was used for colotomy. The endoscope was advanced into the peritoneal cavity. Without making skin incisions, 3 mm in diameter graspers were placed through the abdominal wall under direct endoscopic observation. A rigid liner stapler was advanced into the peritoneal cavity through the colon. A small incision was made in the bowel mesentery by a hook-knife. The stapler was positioned and fired creating a proximal cut end of the small bowel. The distal cut end of the bowel was created in the same manner. The segment of the bowel was resected by firing the stapler one more time, and then extracted through the colon. The two limbs of the small bowel were approximated by suturing. An enterotomy was created on the antimesenteric sides of each line. A side-to-side anastomosis was performed with another application of the stapler. The enterotomy was closed by suturing. The anastomosis was inspected for hemostasis and integrity. The colotomy was closed with endoclips. The endoscope was withdrawn. The transabdominal instruments were removed without placing the sutures. Results: Small bowel resection was successfully performed in all animals. The surgery time -70 minutes. There was no mortality or complications. The animals recovered uneventfully, and survived the 2 weeks post-procedure period. They were placed on a liquid diet for 48 hours after the surgery followed by a regular diet. They remained healthy, and gained weight. Necropsy was performed 2 weeks after the surgery. On necropsy, evaluation of the abdominal skin revealed no scars. The peritoneal cavity was examined. No signs of infection, bleeding, perforations, and adhesions were noted. Endoscopic examination of the colotomy and anastomosis revealed complete healing that was confirmed by histopathology. Conclusions: The study has demonstrated the feasibility of small bowel resection using transcolonic NOTESÔ & transabdominal approach. Simultaneous use of flexible and rigid instruments was not only feasible but also facilitated performance of the operation yet leaving no scars.

Research paper thumbnail of The Ties That Bind: Durable, Transmural, Purse-String-Like Gastrotomy Closure Using a Novel Device

Gastrointestinal Endoscopy, 2007

首页 旧版入口 知识脉络 投稿 专题 相似性检测 更多 ▼. 学术统计分析 专利分析(试用) 跨库检索 新方志 电力行业版 冶金行业版 移动阅读; 查新咨询服务中心 科技文献 身份证核查 编审平... more 首页 旧版入口 知识脉络 投稿 专题 相似性检测 更多 ▼. 学术统计分析 专利分析(试用) 跨库检索 新方志 电力行业版 冶金行业版 移动阅读; 查新咨询服务中心 科技文献 身份证核查 编审平台 DOI注册 OA论文托管 期刊统计分析. 登录 | 注册 | 充值 | 帮助. ...

Research paper thumbnail of Ultrathin endoscopes

Gastrointestinal Endoscopy, 2010

Research paper thumbnail of Mechanisms of Occlusion of Uncoated Self-Expanding Metal Biliary Stents (SEMS): Final Results of a Multi-Center Comparative Study

Gastrointestinal Endoscopy, 2007

No abstract is available. To read the body of this article, please view the Full Text online. ...... more No abstract is available. To read the body of this article, please view the Full Text online. ... © 2007 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution.

Research paper thumbnail of Pancreatic pseudocystgastrostomy with a peroral, flexible stapler: human natural orifice transluminal endoscopic surgery anastomoses in 2 patients (with videos)

Gastrointestinal Endoscopy, 2008

Complex, symptomatic pancreatic pseudocysts often must be surgically drained. Natural orifice sur... more Complex, symptomatic pancreatic pseudocysts often must be surgically drained. Natural orifice surgery is an emerging field in which surgical procedures are performed by using an endoluminal approach through an existing body orifice. Two patients at our institution, an academic, tertiary care center. Two patients who underwent a standard, stapled, surgical cystgastrostomy for drainage of a complex, infected pseudocyst by using a flexible stapling device are described. These procedures were performed under endoscopic observation and guidance, all transorally, without the need for laparotomy or laparoscopy. Both patients had a technically successful outcome, and both did well after surgery, with only mild chest pain and throat discomfort in one, and no adverse sequelae at all in the other patient. Both patients had complete resolution of their complex, debris-filled pseudocysts at 6 weeks when examined by endoscopy and at 3 months when examined by CT. An entirely endoscopic, peroral, stapled pseudocystgastrostomy is feasible and can lead to an excellent outcome. For properly selected patients, this may be an alternative to more traditional types of surgical cystgastrostomy.

Research paper thumbnail of Randomized Controlled Trial (RCT) of a New Nitinol Non-Forshortening Self-Expanding Metal Stent (SEMS) for Malignant Biliary Obstruction: An International Multi-Center Comparison in Two Diameters to WallstentR

Gastrointestinal Endoscopy, 2006

Research paper thumbnail of Endoscopic management of tumors of the major duodenal papilla: Refined techniques to improve outcome and avoid complications

Gastrointestinal Endoscopy, 2001

Background: Adenomas of the major duodenal papilla have malignant potential and are traditionally... more Background: Adenomas of the major duodenal papilla have malignant potential and are traditionally treated by pancreaticoduodenectomy. This is a report of our experience with endoscopic management and a description of techniques for decreasing complications and enhancing efficacy. Methods: Forty-one patients were referred for endoscopic management of papillary tumors. If there was no duct invasion and the appearance suggested a benign lesion, biductal sphincterotomy with pancreatic duct stent placement was performed. If the lesion could be elevated by injection of an epinephrine solution, piecemeal resection was performed. The base of the lesion was thermally ablated as needed. Resection/ablation together with stent removal was performed 1 month later.

Research paper thumbnail of The American Society for Gastrointestinal Endoscopy PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) on peroral endoscopic myotomy

Gastrointestinal Endoscopy, 2015

Research paper thumbnail of Case of chronic pancreatic brucellosis presenting as hemosuccus pancreaticus

JOP : Journal of the pancreas, 2007

Hemosuccus pancreaticus is an uncommon cause of upper gastrointestinal bleeding. Chronic infectio... more Hemosuccus pancreaticus is an uncommon cause of upper gastrointestinal bleeding. Chronic infection of the pancreas with Brucellosis causing hemosuccus pancreaticus has not been previously reported. We describe a case of a 75-year-old man presenting with a pancreatic mass and hemosuccus pancreaticus secondary to chronic pancreatic brucellosis. Polymerase chain reaction analysis of the pancreatic tissue was positive for brucella after an initial positive serology. ERCP revealed bleeding from the pancreatic duct. Computed tomography scans of the abdomen demonstrated an enlarging pancreatic mass. Endoscopic ultrasound showed a cystic mass in the body of the pancreas. Fine needle aspiration revealed granulomata. Selective mesenteric angiogram failed to reveal the source of bleeding. The patient eventually underwent pancreatic resection with resolution of symptoms. This is the first case of hemosuccus pancreaticus due to chronic pancreatic brucellosis reported in medical literature.

Research paper thumbnail of Endoscopic Interventions for Weight Loss Surgery

Research paper thumbnail of Measurement of the quality of care of patients admitted with decompensated cirrhosis

Liver International, 2014

Process-based quality measures are increasingly used to evaluate hospital performance. However, p... more Process-based quality measures are increasingly used to evaluate hospital performance. However, practices vary, and patients with cirrhosis are a challenge to manage, given their risks of mortality, morbidity, and resources utilization. In 2010, process-based quality measures were developed to improve the care of these patients. We examined adherence with these quality measures for a cohort of patients admitted with decompensated cirrhosis in 2009. We performed a retrospective analysis of all patients admitted to a tertiary-care hospital with decompensated cirrhosis in 2009 (n = 149,379) hospitalizations. Quality indicator (QI) scores were calculated for each admission as a fraction, i.e., the number of quality markers met divided by the number of possible quality indices, given the patient's presentation (range, 0-1). QI scores were correlated with patient characteristics and clinical outcomes (30-day readmission; inpatient death). Quality indicators were met 45% of the time (95% confidence interval, 40-51%). In multivariable analysis, QI scores were significantly lower among non-English-speaking patients and those who had congestive heart failure. QI scores were higher among patients with gastrointestinal bleeding or encephalopathy-related admission to the hospital. QI scores were not associated with inpatient mortality or 30-day readmission. There is substantial opportunity to improve the care of patients hospitalized for decompensated cirrhosis. Additional research is needed to identify effective strategies for closing gaps in care. Adherence to quality measures did not affect clinical outcomes, but if easily measured in other settings could be used to compare hospitals and practices.

Research paper thumbnail of Brunner Gland Cyst

International Journal of Surgical Pathology, 2007

Research paper thumbnail of GI endoscopes

Gastrointestinal Endoscopy, 2011

The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technolog... more The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the Committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through September 2010 for articles related to endoscopy by using the key words "gastroscope," "colonoscope," "echoendoscope," "duodenoscope," "choledochoscope," "ultraslim endoscope," "variable stiffness colonoscope," and "wide-angle colonoscope." Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard…

Research paper thumbnail of Minimizing occupational hazards in endoscopy: personal protective equipment, radiation safety, and ergonomics

Gastrointestinal Endoscopy, 2010

Research paper thumbnail of Enteral nutrition access devices

Gastrointestinal Endoscopy, 2010

The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technolog... more The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidencebased methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but, in many cases, data from randomized, controlled trials are lacking. In such situations, large case series, preliminary clinical studies, and expert opinions are used.

Research paper thumbnail of Drug-eluting/biodegradable stents

Gastrointestinal Endoscopy, 2011

DISCLOSURE: J. Tokar is a consultant for Boston Scientific and is a speaker for and recipient of ... more DISCLOSURE: J. Tokar is a consultant for Boston Scientific and is a speaker for and recipient of an educational grant from Fujinon. D. Pleskow is a consultant for Boston Scientific and is on the medical advisory board of Beacon Endoscopic. LM Wong Kee ...

Research paper thumbnail of Enteral stents

Gastrointestinal Endoscopy, 2011

The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews ... more The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases, data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through August 2010 for articles related to enteral, esophageal, duodenal, and colonic stents. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment.

Research paper thumbnail of Training in patient monitoring and sedation and analgesia

Gastrointestinal Endoscopy, 2007

Gastrointestinal Endoscopy, Volume 66, Issue 1, Pages 7-10, July 2007, Authors: Prepared by: Trai... more Gastrointestinal Endoscopy, Volume 66, Issue 1, Pages 7-10, July 2007, Authors: Prepared by: Training Committee; John J. Vargo, MD, MPH, FASGE; Asyia S. Ahmad, MD; Harry R. Aslanian, MD; Jonathan M. Buscaglia, MD; Ananya M. Das, MD; David J. Desilets, MD; Brian J. Dunkin ...

Research paper thumbnail of Autofluorescence imaging

Gastrointestinal Endoscopy, 2011

The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews ... more The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of new or emerging endoscopic technologies that have the potential to affect the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent pre-clinical and clinical studies on the topic and a MAUDE (Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but, in many cases, data from randomized controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. For this review, the MEDLINE database was searched through January 2010 by using the keywords "autofluorescence imaging" and "autofluorescence endoscopy".

Research paper thumbnail of Loop-anchor purse-string versus endoscopic clips for gastric closure: a natural orifice transluminal endoscopic surgery comparison study using burst pressures

Gastrointestinal Endoscopy, 2009

Background: The success of natural orifice surgery depends on a reliable, secure closure of the o... more Background: The success of natural orifice surgery depends on a reliable, secure closure of the opening in the gut. Few tests of the integrity of these closures have been published.

Research paper thumbnail of Gastric Transmural Pressure Measurements In Vivo: Implications for Natural Orifice Transluminal Endoscopic Surgery (NOTES®)

Gastrointestinal Endoscopy, 2009

Background and Aims: NOTESÔ is in evolution. Fundamental NOTESÔ techniques and essential tools fo... more Background and Aims: NOTESÔ is in evolution. Fundamental NOTESÔ techniques and essential tools for performing ''no scar'' surgery still need to be developed. Our study was aimed to evaluate the feasibility of combined use of flexible and rigid instruments in performing surgical procedures without scars. Methods: This experimental study was conducted in a laboratory setting with the approval of the IACUC. Segmental small bowel resection was performed using porcine model. 1 non survival and 2 survival experiments were performed to date. A Veress needle was used to create pneumoperitoneum. The anterior colonic wall was used for colotomy. The endoscope was advanced into the peritoneal cavity. Without making skin incisions, 3 mm in diameter graspers were placed through the abdominal wall under direct endoscopic observation. A rigid liner stapler was advanced into the peritoneal cavity through the colon. A small incision was made in the bowel mesentery by a hook-knife. The stapler was positioned and fired creating a proximal cut end of the small bowel. The distal cut end of the bowel was created in the same manner. The segment of the bowel was resected by firing the stapler one more time, and then extracted through the colon. The two limbs of the small bowel were approximated by suturing. An enterotomy was created on the antimesenteric sides of each line. A side-to-side anastomosis was performed with another application of the stapler. The enterotomy was closed by suturing. The anastomosis was inspected for hemostasis and integrity. The colotomy was closed with endoclips. The endoscope was withdrawn. The transabdominal instruments were removed without placing the sutures. Results: Small bowel resection was successfully performed in all animals. The surgery time -70 minutes. There was no mortality or complications. The animals recovered uneventfully, and survived the 2 weeks post-procedure period. They were placed on a liquid diet for 48 hours after the surgery followed by a regular diet. They remained healthy, and gained weight. Necropsy was performed 2 weeks after the surgery. On necropsy, evaluation of the abdominal skin revealed no scars. The peritoneal cavity was examined. No signs of infection, bleeding, perforations, and adhesions were noted. Endoscopic examination of the colotomy and anastomosis revealed complete healing that was confirmed by histopathology. Conclusions: The study has demonstrated the feasibility of small bowel resection using transcolonic NOTESÔ & transabdominal approach. Simultaneous use of flexible and rigid instruments was not only feasible but also facilitated performance of the operation yet leaving no scars.

Research paper thumbnail of The Ties That Bind: Durable, Transmural, Purse-String-Like Gastrotomy Closure Using a Novel Device

Gastrointestinal Endoscopy, 2007

首页 旧版入口 知识脉络 投稿 专题 相似性检测 更多 ▼. 学术统计分析 专利分析(试用) 跨库检索 新方志 电力行业版 冶金行业版 移动阅读; 查新咨询服务中心 科技文献 身份证核查 编审平... more 首页 旧版入口 知识脉络 投稿 专题 相似性检测 更多 ▼. 学术统计分析 专利分析(试用) 跨库检索 新方志 电力行业版 冶金行业版 移动阅读; 查新咨询服务中心 科技文献 身份证核查 编审平台 DOI注册 OA论文托管 期刊统计分析. 登录 | 注册 | 充值 | 帮助. ...

Research paper thumbnail of Ultrathin endoscopes

Gastrointestinal Endoscopy, 2010

Research paper thumbnail of Mechanisms of Occlusion of Uncoated Self-Expanding Metal Biliary Stents (SEMS): Final Results of a Multi-Center Comparative Study

Gastrointestinal Endoscopy, 2007

No abstract is available. To read the body of this article, please view the Full Text online. ...... more No abstract is available. To read the body of this article, please view the Full Text online. ... © 2007 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution.

Research paper thumbnail of Pancreatic pseudocystgastrostomy with a peroral, flexible stapler: human natural orifice transluminal endoscopic surgery anastomoses in 2 patients (with videos)

Gastrointestinal Endoscopy, 2008

Complex, symptomatic pancreatic pseudocysts often must be surgically drained. Natural orifice sur... more Complex, symptomatic pancreatic pseudocysts often must be surgically drained. Natural orifice surgery is an emerging field in which surgical procedures are performed by using an endoluminal approach through an existing body orifice. Two patients at our institution, an academic, tertiary care center. Two patients who underwent a standard, stapled, surgical cystgastrostomy for drainage of a complex, infected pseudocyst by using a flexible stapling device are described. These procedures were performed under endoscopic observation and guidance, all transorally, without the need for laparotomy or laparoscopy. Both patients had a technically successful outcome, and both did well after surgery, with only mild chest pain and throat discomfort in one, and no adverse sequelae at all in the other patient. Both patients had complete resolution of their complex, debris-filled pseudocysts at 6 weeks when examined by endoscopy and at 3 months when examined by CT. An entirely endoscopic, peroral, stapled pseudocystgastrostomy is feasible and can lead to an excellent outcome. For properly selected patients, this may be an alternative to more traditional types of surgical cystgastrostomy.

Research paper thumbnail of Randomized Controlled Trial (RCT) of a New Nitinol Non-Forshortening Self-Expanding Metal Stent (SEMS) for Malignant Biliary Obstruction: An International Multi-Center Comparison in Two Diameters to WallstentR

Gastrointestinal Endoscopy, 2006

Research paper thumbnail of Endoscopic management of tumors of the major duodenal papilla: Refined techniques to improve outcome and avoid complications

Gastrointestinal Endoscopy, 2001

Background: Adenomas of the major duodenal papilla have malignant potential and are traditionally... more Background: Adenomas of the major duodenal papilla have malignant potential and are traditionally treated by pancreaticoduodenectomy. This is a report of our experience with endoscopic management and a description of techniques for decreasing complications and enhancing efficacy. Methods: Forty-one patients were referred for endoscopic management of papillary tumors. If there was no duct invasion and the appearance suggested a benign lesion, biductal sphincterotomy with pancreatic duct stent placement was performed. If the lesion could be elevated by injection of an epinephrine solution, piecemeal resection was performed. The base of the lesion was thermally ablated as needed. Resection/ablation together with stent removal was performed 1 month later.