A two-step method for marking polypectomy sites in the colon and rectum

Surgical usefulness of indocyanine green as an alternative to India ink for endoscopic marking

“…Endoscopic marking was performed according to a modification of previously reported procedures [11,12]. First, 2 ml of normal saline solution (Otsuka Pharmaceutical Co., Ltd., Japan) was injected tangentially into the submucosal layer to form a submucosal elevation.…”

“…Moreover, no proof exists to date for the long-term safety of this practice [10]. Several specialists have described new methods to prevent improper injection of India ink into the muscularis propria or peritoneal cavity [11,12], thus indicating the difficulty that general endoscopists face when injecting the dye properly into the submucosa.…”

A novel endoscopic fluorescent clip for the localization of gastrointestinal tumors

“…Among several tattooing agents, SPOT Ò (GI Supply, Camp Hill, PA) is proven to be a safe and effective agent and is widely used. However, the leakage and local spreading of ink can make it difficult to identify the tumor's location [2,6,12,13]. Many clinicians are looking for a new tumor-localizing method that is simple, accurate, and less invasive.…”

Black Macular Patches on Parietal Peritoneum and Other Extraintestinal Sites from Intraperitoneal Spillage and Spread of India Ink from Preoperative Endoscopic Tattooing: An Endoscopic, Surgical, Gross Pathologic, and Microscopic Study

“…Contrariwise, the risk of intraperitoneal injection is minimized by shallow penetration of the sclerotherapy needle tip into the colonic wall; tangential injection; creation of a submucosal bleb; careful, slow, and moderate pressure injection; and injection of small aliquots [4,17]. Preliminary formation of a submucosal bleb with normal saline before India ink injection has also been reported to prevent intraperitoneal injection [18,19]. These precautions are particularly important in the thin-walled cecum.…”