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Colonoscopy:Ascending Colon Resection after two prior failed resections

  • 169
  • 10 Months Ago
Lesion: Subtle flat lesion (required chromoendoscopy and near focus imaging to define it). Previously resected and then ablated with a BICAP. Location: Proximal ascending colon Cap fitted colonoscope - adult scope: Cap helps to check the area better by moving folds or flattening folds; latest adult endoscope with near focus function helps to define the lesion and its extent. Optical Diagnosis: Adenoma Injection: Saline with Methylene Blue 8cc; Note: Inject away from the scar. Submucosal injection lift: Good towards the IC valve; not so good towards the anus side on 2nd injection. Snare: Select a small snare in tough resections as the lesion tends to slip out due to underlying scar tissue (used a 10 mm snare) Electrocautery: Endocut Q 3-1-3; three cuts Hot biopsy avulsion: Endocut I 2-1-1 Check the resection site with serial photos using a biopsy forceps if need be to flatten the area for better examination. APC: 0.8lts, 35 W, Forced Clip closure: 5 clips

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