بایگانی برچسب برای: Endoluminal

NOTES.and.Endoluminal.Surgery.[taliem.ir]

NOTES and Endoluminal Surgery

Natural orifice translumenal endoscopic surgery (NOTES™) was officially born in 2005 when a forward thinking group of gastroenterologists and surgeons convened to discuss, organize, codify, and elucidate concerns about this potential new disruptive surgical idea. This meeting came on the heels of a report of “flexible transgastric peritoneoscopy” from Johns Hopkins University and several subsequent experiments in animal models expanding upon the possibilities this technique represented . The NOTES moniker was adopted at this meeting, as was the formation of the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR®) . But a peek into the history of surgery via the natural orifice reveals that the idea was an old one, dating back into the 1800s in some cases. Many animal experiments were performed, demonstrating many new and novel techniques to commonly performed operations, and scientific investigation was undertaken to determine the safety and feasibility of these approaches. Human work began to emerge in 2005 and continues to develop; in some cases, becoming widely adopted.
Advanced Colonoscopy and Endoluminal Surgery[taliem.ir]

Advanced Colonoscopy and Endoluminal Surgery

Philipp Bozzini is considered by many the father of endoscopy. Born in Mainz, Germany, in 1773, Bozzini’s goal was to examine the inner cavities of the human body in designing the Lichtleiter, or “light conductor.” He recognized the importance of direct observation in the ability to understand the physiology and function of human organs . With his design, he also foresaw the ability to perform new procedures and to make existing procedures safer by allowing, for instance, the removal of rectal polyps or cervical tumors to be done under direct visualization rather than to depend on luck. The original Lichtleiter consisted of a vase-shaped lantern made of tin and covered with leather . Within this housed the light source, a wax candle, on a spring device designed to keep the flame at a constant height. A concave mirror was placed to project light through an aperture, onto which various tubular specula could be attached. The mirror directed light toward the hollow organ and avoided reflection toward the observer’s eye . On the opposite side was another fenestration onto which an eyepiece was attached for the observer . The tubular specula were made of brass or silver and modifed based of the organ they were meant for: urethra, vagina, rectum, and so on . His conductors were straight to avoid deviating from the straight lines on which light rays travel. In order to observe objects at an angle, for instance behind the nasopharynx, he used a mirror to bend the light. He did note, however, that bending the light compromised the clarity of the image