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Detorsion of sigmoid volvulus by flexible fiberoptic sigmoidoscopy.
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Sigmoidoscopy.
Rigid sigmoidoscopy is an obligatory part of the routine anorectal examination and enables inspection of the rectum in nearly every case. The extent of bowel examined by flexible sigmoidoscopy is greater and more abnormalities are therefore discovered. With suitable organization, flexible sigmoidoscopy is practicable in the outpatient department. Neither technique examines the large bowel completely so air-contrast barium enema examination with colonoscopy is necessary and should be requested if more proximal disease is thought possible.
[Experiences with flexible rectosigmoidoscopy].
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[Advantages and limits of rigid rectosigmoidoscope and flexible colonoscope in childhood].
During the past ten years 220 pediatric proctosigmoidoscopies with the rigid instrument in 182 infants and children, and 71 colonoscopies in 62, were performed. Advantages and limits of these two instruments are discussed. The indications and results of the different procedures are presented. Positive diagnoses were obtained in 81% with both techniques while the histological examination was positive in 85% of specimens obtained by colonoscopy and only in 51% of the proctosigmoidoscopical ones. Colonoscopy has increasingly became a complementary method for colonic pathology in children, in comparison with adult medicine, however, pediatric indications have been handled mostly with the shorter instrument for two main reasons: 1) Pediatric colonic pathology affects predominantely the lower tract; 2) Neoplastic lesions, in which total colonoscopy with biopies at different levels is mandatory, are extremely rare in children.
The short fiber-optic colonoscope (preliminary report).
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Flexible sigmoidoscopy.
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[Reduction of sigmoid volvulus with the flexible colonoscope].
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Flexible sigmoidoscopy.
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Colon cancer screening: the case for sigmoidoscopy.
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Value of flexible sigmoidoscopy.
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Accuracy of double contrast barium enema and sigmoideoscopy in the detection of polyps in patients with diverticulosis.
The sensitivity between double contrast barium enema (DCBE) and sigmoideoscopy in diagnosing neoplastic lesions in the sigmoid colon was compared in patients with diverticulosis. In 52 patients with severe diverticulosis (> or = 15 diverticulas) the DCBE detected one out of 4 polyps found by sigmoideoscopy. In the remaining 54 patients with mild diverticulosis (< 15 diverticulas) DCBE detected 7 out of 10 polyps found by sigmoideoscopy. Successful bowel preparation did not influence the outcome of the DCBE. Sigmoideoscopy was incomplete in 17 (16%) of the patients; females were more difficult to examine than males (p = 0.012), as were those with a previous pelvic operation (p = 0.032). We conclude that neither DCBE nor sigmoideoscopy alone is sufficient to detect all neoplastic lesions in the sigmoid colon in patients with sigmoid diverticulosis of the colon.
Flexible fibreoptic sigmoidoscopy. Safe and effective for family practice.
Flexible fibreoptic sigmoidoscopy can detect malignancy, polyps, and other common diseases of the large bowel when they are distal to the splenic flexure. The procedure is safe and not painful when correctly performed. Family physicians could play an important role in the earlier diagnosis and prevention of colorectal cancer by adding the procedure to their repertoire.
Utilization of sigmoidoscopy by family physicians in Canada.
OBJECTIVE: To determine the extent to which sigmoidoscopy is used as an investigative tool by family physicians in Canada. DESIGN: Retrospective study of data from provincial and territorial health agencies for the fiscal year 1989. SETTING: Canada. PARTICIPANTS: All family physicians. MAIN OUTCOME MEASURES: Number of physicians in each province and territory who performed sigmoidoscopy (flexible and rigid), type of physician (generalist or specialist), number of procedures performed, fee schedule and number of physicians billing medicare in each province and territory. RESULTS: During the study period 3849 (15.1%) of all family physicians performed rigid sigmoidoscopy; the proportion varied from 3.4% (in Quebec) to 40.0% (in the Northwest Territories). A total of 43,914 rigid sigmoidoscopies were performed by family physicians, representing 23% of all such procedures. Flexible sigmoidoscopy was performed by 381 (1.5%) of all family physicians; the proportion varied from 0.4% (in Quebec) to 6.8% (in Prince Edward Island). A total of 5361 flexible sigmoidoscopies were performed, representing 6.0% of all such procedures. CONCLUSION: The proportion of Canadian family physicians who are using sigmoidoscopy, rigid or flexible, as a diagnostic tool is low.
Evaluation of an optical system in the fibercolonoscope: trial manufacture of an instrument with 30 degrees deviation optical system.
To evaluate the best optical system for colonoscopy a colonofibrescope was manufactured in which the optical system had a 30 degrees prograde deviation. In this test model, frontal view was easily obtained and close-up observations were possible. At areas with prominent semilunar folds, the zone behind them also came into full view. The bowel lumen could be visualized by angulation, the same as with conventional instruments. The passage trough the sigmoid-descending junction was easy, and visualization or the colon up to the distal transverse colon was accomplished within a short time in the majority of cases without fluoroscopic control.
Development of steerable instruments for minimal invasive surgery in modular conception.
The augmenting complexity of minimal invasive interventions requests a continuous improvement of technologies. Extended endoscopic procedures, e.g. laparoscopic-transanal sigmoidectomy or thoracoscopic esophagus dissection require difficult surgical manipulations like mobilisation, sceletonization as well as ligatures and sutures. They are difficult to perform with the present endo-surgical instruments. A major instrumental weakness is represented by the restricted steerability because of the rigid shaft axis and the resulting low degrees of freedom (DOF). Therefore a series of steerable flexible instruments has been developed in interdisciplinary cooperation between surgeons and engineers. The prototypes provide a multi-joint working as the instrument's elbow, which allows to incline the tip around +/- 280 degrees. The second additional DOF is the rotation of the surgical tool. The prototypes have been experimentally tested in laparoscopy and thoracoscopy, showing a clear improvement in the carrying out of complex operative manipulations. The further development is performed in modular conception, including electric drives.
Demographic differences in African-American patients with neoplastic lesions detected by flexible sigmoidoscopy.
There is a higher incidence of colorectal cancer in young African-American patients compared with white Americans. This study examines the incidence, demographic pattern, and distribution of neoplastic lesions identified by flexible sigmoidoscopy in an African-American population. A sample of charts was reviewed from an urban gastroenterology practice that serves predominantly African Americans. A total of 455 patients were found who underwent flexible sigmoidoscopy. The sample included 391 symptomatic patients and 64 asymptomatic patients. Two hundred fifty-five patients were < 50 years old and 200 patients were > or = 50 years. More neoplastic lesions were found among older patients (21 patients: 14 with polyps and 7 cancers) than among younger patients (7 patients: 3 with polyps and 4 cancers); the difference of all positive findings between the two groups was significant. However, the cancerous rate for younger patients was not statistically different from that for older patients. These findings suggest that young African-American patients with colorectal symptoms should undergo aggressive approaches to detect cancer early.