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Active gastrointestinal bleeding:Use of hemostatic forceps beyond endoscopic submucosal dissection

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World Journal of Gastroenterology 2010年第16期16卷 2061-2064页

作者： Dimitri Coumaros Niki Tsesmeli Department of Hepatogastroenterology University Hospital of Strasbourg

To the best of our knowledge,this is the f irst report of the application of hemostatic forceps in active gastrointestinal(GI) bleeding that is not related to endoscopic submucosal *** 86-year-old woman with chronic intake of low-dose aspirin had a Dieulafoy's lesion of the third duodenal *** control with epinephrine injection was unsuccessful.A 60-year-old man presented with a bleeding ulcer in the duodenal *** days after combined endotherapy,he had recurrent bleeding from two minimal lesions in the same location.A 66-year-old woman under combined antithrombotic treatment was referred to us for chronic GI bleeding of unexplained *** revealed active diverticular bleeding in the second duodenal portion.A 61-year-old woman underwent endoscopic mucosal resection of superficial gastric adenocarcinoma,which was complicated with immediate *** all cases,the blood was washed out using a water-jet-equipped,single-channel gastroscope with a large working *** bleeding points were pinched and retracted with hemostatic *** electrocoagulation was performed using an electrosurgical current *** was *** complications *** conclusion,hemostatic forceps may be an effective as well as safe alternative approach for active GI bleeding of various origins.

关键词： Hemostasis forceps Blood coagulation Hemorrhage Endoscopic submucosal dissection

Improved specimen adequacy using jumbo biopsy forceps in patients with Barrett's esophagus

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World Journal of Gastroenterology 2015年第17期21卷 5328-5335页

作者： Jan Martinek Jana Maluskova Magdalena Stefanova Inna Tuckova Stepan Suchanek Zuzana Vackova Jana Krajciova Marek Kollar Miroslav Zavoral Julius Spicak Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine14021 PragueCzech Republic Faculty of Medicine University of Ostrava70103 OstravaCzech Republic Department of Pathology IKEM14021 PragueCzech Republic Department of Internal Medicine Hospital "Na Frantisku"11000 PragueCzech Republic Department of Pathology Central Military Hospital16902 PragueCzech Republic Department of Medicine Charles UniversityMilitary University Hospital16902 PragueCzech Republic

AIM:To assess the sampling quality of four different forceps(three large capacity and one jumbo) in patients with Barrett's ***:This was a prospective,single-blind study.A total of 37 patients with Barrett's esophagus were *** or random biopsies with all four forceps were obtained from each patient using a diagnostic endoscope during a single *** following forceps were tested:A:FB-220 K disposable large capacity;B:BI01-D3-23 reusable large capacity;C:GBF-02-23-180 disposable large capacity;and jumbo:disposable Radial Jaw 4 *** primary outcome measurement was specimen adequacy,defined as a well-oriented biopsy sample 2 mm or greater with the presence of muscularis ***:A total of 436 biopsy samples were *** found a significantly higher proportion of adequate biopsy samples with jumbo forceps(71%)(P forceps A:26%,forceps B:17%,and forceps C:18%).Biopsies with jumbo forceps had the largest diameter(median 2.4 mm)(P forceps A:2 mm,forceps B:1.6 mm,and forceps C:2mm).There was a trend for higher diagnostic yield per biopsy with jumbo forceps(forceps A:0.20,forceps B:0.22,forceps C:0.27,and jumbo:0.28).No complications related to specimen sampling were observed with any of the four tested ***:Jumbo biopsy forceps,when used with a diagnostic endoscope,provide more adequate specimens as compared to large-capacity forceps in patients with Barrett's esophagus.

关键词： Barrett's esophagus Barrett's esophagusrelatedneoplasia Biopsy forceps Jumbo forceps Specimen adequacy

Use of disposable graduated biopsy forceps improves accuracy of polyp size measurements during endoscopy

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World Journal of Gastroenterology 2015年第2期21卷 623-628页

作者： Hei-Ying Jin Qiang Leng National Center of Colorectal Surgery the Third Affiliated Hospital of Nanjing University of Traditional Chinese MedicineJiangsu Integrated Colorectal Oncology Center

AIM: To determine the accuracy of endoscopic polyp size measurements using disposable graduated biopsy forceps(DGBF). METHODS: Gradations accurate to 1 mm were assessed with the wire of disposable graduated biopsy forceps. When a polyp was noted, endoscopists determined the width of the polyp; then, the graduated biopsy forceps was inserted and the largest diameter of the tumor was measured. After excision, during surgery or endoscopy, the polyp was measured using the vernier ***: One hundred and thirty-three colorectal polyps from 119 patients were studied. The mean diameter, by post-polypectomy measurement, was 0.92 ± 0.69 cm; 83 were 2 cm. The mean diameter, by visual estimation, was 1.15 ± 0.88 cm; compared to the actual size measured using vernier calipers, the difference was statistically significant. The mean diameter measured using the DGBF was 0.93 ± 0.68 cm; compared to the actual size measured using vernier calipers, this difference was not statistically significant. The ratio between the mean size estimated by visual estimation and the actual size was significantly different from that between the mean size estimated using the DGBF and the actual size(1.26 ± 0.30 vs 1.02 ± 0.11).CONCLUSION: The accuracy of polyp size estimation was low by visual assessment; however, it improved when the DGBF was used.

关键词： Disposable graduated biopsy forceps Polyp size mea

Evaluation of novel slim biopsy forceps for diagnosis of biliary strictures: Single-institutional study of consecutive 360 cases(with video)

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World Journal of Gastroenterology 2017年第35期23卷 6429-6436页

作者： Kenjiro Yamamoto Takayoshi Tsuchiya Takao Itoi Shujiro Tsuji Reina Tanaka Ryosuke Tonozuka Mitsuyoshi Honjo Shuntaro Mukai Kentaro Kamada Mitsuru Fujita Yasutsugu Asai Yukitoshi Matsunami Yuichi Nagakawa Hiroshi Yamaguchi Atsushi Sofuni Department of Gastroenterology and Hepatology Tokyo Medical University Third Department of Surgery Tokyo Medical University Department of Pathology Tokyo Medical University

AIM To evaluate the feasibility and reliability of endoscopic transpapillary bile duct biopsy for the diagnosis of biliary *** A total of 360 patients(241 men) who underwent endoscopic retrograde cholangiopancreatography for biliary strictures with biopsy from April 2012 to March 2016 at Tokyo Medical University Hospital were retrospectively reviewed. This study was approved by our Institutional Review Board(No. 3516). Informed consent was obtained from all individual participants included in this study. The biopsy specimens were obtained using a novel slim biopsy forceps(Radial Jaw 4P, Boston Scientific, Boston, MA, United States).RESULTS The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 69.6%, 100%, 100%, 59.1%, and 78.8%, respectively. The sensitivity was 75.6% in bile duct cancer, 64% in pancreatic cancer, 61.1% in gallbladder cancer, and 57.1% in metastasis. In bile duct cancer, a lower sensitivity was observed for perihilar bile duct stricture(68.7%) than for distal bile duct stricture(83.1%). In terms of the stricture lengths of pancreatic cancer, gallbladder cancer, and metastasis, a longer stenosis resulted in a better sensitivity. In particular, there was a significant difference between pancreatic cancer and gallbladder cancer(P forceps is feasible and reliable, but restrictive. Biopsy should be performed in consideration of the stricture level, stricture length, and cancer type.

关键词： Endoscopic transpapillary biopsy Biopsy forceps Biliary stricture Bile duct cancer Endoscopic retrograde cholangiography

Should hot biopsy forceps be abandoned for polypectomy of diminutive colorectal polyps?

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World Journal of Gastroenterology 2018年第14期24卷 1579-1582页

作者： Vasileios Panteris Antonios Vezakis Jk Triantafillidis Department of Gastroenterology Sismanogleio-A.Fleming General Hospital Department of Surgery Aretaieio Hospital Department of Gastroenterology Iaso General Hospital

Standardized approach to polypectomy of diminutive colorectal polyps(DCPs) is lacking since cold biopsy forceps have been associated with high levels of recurrence, hot biopsy forceps are considered inadequate and risky and cold snaring is currently under investigation for its efficacy and safety. This has led to confusion and a gap in clinical practice. This article discusses the usefulness and contemporary practical applicability of hot biopsy forceps and provides wellintentioned criticism of the new European guidelines for the treatment of DCPs. Diminutive colorectal polyps are a source of frustration for the endoscopist since their small size is accompanied by a considerable risk of premalignant neoplasia and a small but nonnegligible risk of advanced neoplasia and even cancer. Since the proportion of diminutive colorectal polyps is substantial and exceeds that of larger polyps, their effective removal poses a considerable workload and a therapeutic challenge. During the last decade, the introduction of cold snaring to routine endoscopy practice has attempted to overcome the use of prior techniques, such as hot biopsy forceps. It is important to recognize that with the exception of endoscopic methods that are obviously unsafe and inadequate to serve their purpose, all other interventional endoscopic methods are operator-dependent in the sense that specific expertise and training are obligatory for the success of any therapeutic intervention. Since relevant publications on hot biopsy forceps are still in favor of its careful use, as it has not yet demonstrated inferiority compared with newer techniques, it would be prudent for any medical practitioner to evaluate the available tools and judge any new proposed technique based on the evidence before it is adopted.

关键词： Hot forceps Polypectomy Endoscopy Colon neoplasia Diminutive polyps

Removal of a large foreign body in the rectosigmoid colon by colonoscopy using gastrolith forceps

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World Journal of Clinical Cases 2016年第5期4卷 135-137页

作者： Xiao-Dong Lin Guang-Yao Wu Song-Hu Li Zong-Quan Wen Fu Zhang Shao-Ping Yu Department of Gastro-enterology Dongguan Kanghua Hospital

Rectal foreign bodies are man-made injury that occurs *** management depends on its depth and the consequence it *** here report a case of rectal foreign body(a glass bottle measuring about 38 mm×75 mm)which was located 13-15 cm from the *** patient had no sign of perforation,and we managed to remove it using endoscopy with gastrolith forceps.

关键词： Foreign body Rectosigmoid Endoscopy Removal Gastrolith forceps

forceps Delivery at the Maternity Ward of Donka National Teaching Hospital Conakry (Guinea): Indications and Maternal-Fœtal Prognosis

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Open Journal of Obstetrics and Gynecology 2019年第4期9卷 502-510页

作者： M. H. Diallo I. S. Baldé O. Baldé B. S. Diallo A. Diallo I. Sylla B. Diallo A. D. Diallo Y. Hyjazi N. Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea University Department of Visceral Surgery Donka National Hospital Conakry Guinea

Objectives: The objectives of this work were to describe the socio-demographic, clinical and prognostic characteristics of forceps deliveries at the maternity ward of the Donka National Teaching Hospital of Conakry. Parturients and Method: This was a prospective and descriptive study of all forceps deliveries performed at the Donka National Hospital maternity ward over a 6-month period from April 1, 2018 to September 30, 2018. Results: We performed 90 fetal extractions by forceps on 3518 deliveries i.e. a frequency of 2.55%. The socio-demographic profile of the parturient women was that of a young primiparous woman with an average age of 21.20 years and a full-term pregnancy with an average gestational age of 39 weeks of amenorrhoea. Fore position varieties were the most frequent with, in order of frequency, the fore left occipito-iliac (61.3%) and the fore right occipito-iliac (22.22%). Posterior varieties accounted for 15.55% of cases. Clinical pelvimetry showed that 88.89% of parturients had a practicable pelvis, while 11.11% had a moderately narrow pelvis. Acute fetal suffering was the most common indication (55.56%), followed by maternal exhaustion (27.78%) and prolonged expulsion (16.67%). All forceps were performed by doctors. We noted 8 cases of forceps failure (8.88%) that required a cesarean section. Maternal complications were dominated by soft tissue lesions, including 7 cases of perineal tearing (7.77%);4 cases of vaginal tearing (4.44%);3 cases of cervical tearing (3.33%) and 2 cases of hemorrhage of delivery by uterine atony (2.22%). No cases of maternal death have been recorded. The majority of newborns had a normal birth weight (88.88%) and more than half of newborns (66.66%) had an Apgar score below 7 out of 10 at the first minute. By the fifth minute there was an improvement in Apgar’s score from an average of 5 to 8 out of 10. Five newborns died, or 5.55%. Conclusion: forceps extractions are less and less practiced in our maternity wards. Their b

关键词： forceps Delivery Complications Conakry

Basic Characteristics of the Hydraulic-Driven forceps for Force Feedback

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Journal of Mechanics Engineering and Automation 2015年第9期5卷 519-524页

作者： Tohru Sasaki Yasuyuki Mito Mitsuru Jindai Yusuke Ikemoto Graduate School of Science and Engineering for Research University of Toyama Toyama 930-8555 Japan Graduate School of Science and Engineering for Education University of Toyama Toyama 930-8555 Japan

A surgical manipulator has widely been used for laparoscopic surgery. It has been chosen mainly for the use in supporting human operations and in robot systems like the da Vinci surgical system. These manipulator systems are suitable for careful work, but they have a few problems. One of the problems is that the manipulator is not equipped with haptic sensing functions. Therefore, the operator must know the advanced techniques for visually detecting the physical contact state during surgical operations. These haptic sensing functions thus need to be incorporated into a surgical manipulator. We have developed hydraulic-driven forceps with a micro bearing and a bellows tube that can convey haptic sense to the operator. This system can measure the small forces acting on the tips of the forceps using Pascal＇s principle. A model of the system is provided from the relationship between the internal pressure of the bellows tube and the refraction angles of the forceps. It was confirmed using this model that the developed system makes it possible to estimate both the strength and the direction of the external force applied to the forceps by measuring the internal pressure of the bellows tube. An operator using a three-dimensional haptic device was able to feel the force response during an experiment in which they used the forceps to hold a blood vessel. This report describes the most appropriate method for letting the operator feel the force conveyed by using our system.

关键词： Hydraulic-driven forceps force feedback surgical manipulator.

A new breakthrough:ESD using a newly developed grasping type scissor forceps for early gastrointestinal tract neoplasms

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World Journal of Gastrointestinal Endoscopy 2010年第3期2卷 90-96页

作者： Kazuya Akahoshi Hidefumi Akahane Department of Gastroenterology Aso Iizuka Hospital Design Group Endoscopy Systems Div-isionMedical System Business DivisionFujifi lm Corpo ration

Endoscopic submucosal dissection(ESD) has allowed the achievement of histologically curative en bloc resection of gastrointestinal neoplasms regardless of size,permitting the resection of previously non-resectable *** ESD technique for treatment of early gastric cancer has spread rapidly in Japan and a few other Asian countries due to its excellent eradication rate compared to endoscopic mucosal *** numerous electrosurgical knives have been developed for ESD,technical difficulties and high complication rates(bleeding and perforation) have limited their use *** developed the grasping type scissor forceps(GSF) to resolve such ESD-related *** animal and preliminary clinical studies showed that ESD using GSF is a safe(no intraoperative complication) and technically efficient(curative en bloc resection rate 92%) method for dissection of early gastrointestinal *** use of GSF is a promising option for performing ESD on early stage GI tract tumors both safely and effectively.

关键词： Endoscopic sub mucosal dissection Novel device Grasping type scissor forceps Early gastro-intestinal tract neoplasms Endoscopic therapy