Colonoscopy in flowing water for lower GI bleeding: A reliable method for confirmation of bleeding points for endoscopic treatment

Yamamoto, Hironori; Koiwai, Hirobumi; Sekine, Yutaka; Sunada, Fumiko; Iino, Shoichiro; Ido, Kenichi; Sugano, Kentaro

doi:10.1067/mge.2000.109873

Cited by 7 publications

(4 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Others reported that in patients with difficult colonoscopy due to lower gastrointestinal bleeding 23,24 , including those with sigmoid resection and immediate post-operative hemorrhage 25 , the source of bleeding could be diagnosed more readily when the colonic lumen was filled with water. The use of water as an adjunct to air insufflation described almost three decades ago facilitated passage through segments of severe diverticulosis.…”

Section: Discussionmentioning

confidence: 99%

The water method is effective in difficult colonoscopy—it enhances cecal intubation in unsedated patients with a history of abdominal surgery

Leung¹,

Mann²,

Leung³

et al. 2011

jig

View full text Add to dashboard Cite

Background: colonoscopy in unsedated patients in the Us is considered to be difficult. success rate of cecal intubation is limited by discomfort. colonoscopy in patients with a history of abdominal surgery is also considered to be difficult due to adhesion-related bowel angulations. The water method has been shown to significantly reduce pain during colonoscopy. Objective: To test the hypothesis that the water method enhances the completion of colonoscopy in unsedated patients with a history of abdominal surgery. Design: The data bases of two parallel RcT were combined and analyzed. Setting: Two Veterans affairs endoscopy units. Patient and Methods:The water and air methods were compared in these two parallel RcT examining unsedated patients. Those with a history of abdominal surgery were selected for evaluation. Main Outcome Measurements: completion of unsedated colonoscopy. Results: among patients with a history of abdominal surgery, the proportion completing unsedated colonoscopy in the water group (19 of 22) was significantly higher than that (11 of 22) in the air group (p=0.0217, Fisher's exact test). Limitations: small number of predominantly male veterans, unblinded colonoscopists, not all types of abdominal surgery (e.g. hysterectomy, gastrectomy) predisposing to difficult colonoscopy were represented. Conclusion: This proof-of-principle assessment confirms that in patients with a history of abdominal surgery the water method significantly increases the proportion able to complete unsedated colonoscopy. The water method deserves to be evaluated in patients with other factors associated with difficult colonoscopy.

show abstract

Section: Discussionmentioning

confidence: 99%

The water method is effective in difficult colonoscopy—it enhances cecal intubation in unsedated patients with a history of abdominal surgery

Leung¹,

Mann²,

Leung³

et al. 2011

jig

View full text Add to dashboard Cite

show abstract

“…During endoscopy for gastrointestinal bleeding, it is often difficult to secure the visual field due to massive bleeding in the lumen. Although the water immersion technique has been used 1 2 3 , it often fails to secure the visual field, because injected/infused water is rapidly mixed with blood and residue. Although endoscopic resection with the water (water or saline) immersion technique has become popular 4 5 6 7 , it is difficult to secure the visual field in case of intraprocedural bleeding 7 .…”

Section: Introductionmentioning

confidence: 99%

Development of a gel dedicated to gel immersion endoscopy

et al. 2021

Self Cite

View full text Add to dashboard Cite

Backgrounds and study aims Gel immersion endoscopy is a novel technique to secure the visual field during endoscopy. The aim of this study was to develop a dedicated gel for this technique. Methods To identify appropriate viscoelasticity and electrical conductivity, various gels were examined. Based on these results, the dedicated gel “OPF-203” was developed. Efficacy and safety of OPF-203 were evaluated in a porcine model. Results In vitro experiments showed that a viscosity of 230 to 1900 mPa·s, loss tangent (tanδ) ≤ 0.6, and hardness of 240 to 540 N/cm2 were suitable. Ex vivo experiments showed electrical conductivity ≤ 220 μS/cm is appropriate. In vivo experiments using gastrointestinal bleeding showed that OPF-203 provided clear visualization compared to water. After electrocoagulation of gastric mucosa in OPF-203, severe coagulative necrosis was not observed in the muscularis but limited to the mucosa. Conclusions OPF-203 is useful for gel immersion endoscopy.

show abstract

“…The technique of colonoscopy remains fairly standard, although a study by Yamamoto et al [9] described a simple technique for localizing acute colonic bleeding site by performing colonoscopy in flowing water. This technique enabled exact detection and localization of the actively bleeding point for endoscopic treatment of LGIB.…”

Section: Opinion Statementmentioning

confidence: 98%

Endoscopic management of lower gastrointestinal bleeding

Arya

Marcon

2004

Curr Treat Options Gastro

View full text Add to dashboard Cite

Colonoscopy continues to be the primary tool for diagnostic evaluation and management of lower gastrointestinal bleeding (LGIB). With the advent of newer endoscopy delivery therapeutic modalities, the treatment of LGIB has changed dramatically over the decades. The most dramatic change has been the role of surgery, which has been substantially reduced due to the therapeutic colonoscopy. This article reviews recent advances in the endoscopic treatment options in LGIB of the colon and rectum.

show abstract

Colonoscopy in flowing water for lower GI bleeding: A reliable method for confirmation of bleeding points for endoscopic treatment

Cited by 7 publications

References 2 publications

The water method is effective in difficult colonoscopy—it enhances cecal intubation in unsedated patients with a history of abdominal surgery

The water method is effective in difficult colonoscopy—it enhances cecal intubation in unsedated patients with a history of abdominal surgery

Development of a gel dedicated to gel immersion endoscopy

Endoscopic management of lower gastrointestinal bleeding

Contact Info

Product

Resources

About