Running endoscopy unit

PURPOSE: The detection of where an organ starts and where it ends is achievable and, since this information can be delivered in real time, it could be quite important for several reasons. For one, by having the practical knowledge of the Wireless Endoscopic Capsule (WEC) transition through an organ's domain, we are able to align and control the endoscopic operation with any other possible protocol, i.e., delivering some form of treatment on the spot. Another is having greater anatomical topography information per session, therefore treating the individual in detail (not "in general")...

Enteral feed bezoars are a rare and difficult to treat complication of enteral feeding. In our case, we report the case of a young man with prolonged admission at the intensive care unit; who requires enteral nutrition. This doesn't run properly after a week; which is why we performed an endoscopy with the finding of an esophageal bezoar that didn't respond to endoscopic treatment at first; being finallay resolved with a second endoscopic therapy after treatment with solvent substances.

Pediatric endoscopy is an essential clinical practice used to diagnose and treat gastrointestinal diseases in children. Moreover, pediatric endoscopy programs require a clinically and technically specialized unit organized around performing endoscopic procedures with high levels of training and skill. With the volume of endoscopic procedures steadily rising in large academic medical centers each year, achieving operational efficiency has become critical to running a successful endoscopy program.

BACKGROUND: Patients presenting for evaluation of umbilical and epigastric hernias are often found to have diastasis recti (DR). As isolated hernia repair in these patients may be associated with higher rates of recurrence, prior international publications have described a prefascial mesh repair in combination with anterior plication of DR. We present our initial United States (US) experience with a SubCutaneous OnLay endoscopic Approach (SCOLA) to address these concurrent pathologies in a single hybrid procedure...

Endoscopy units face numerous challenges because of rising demand, increased operational costs, and declining reimbursement. These conditions have led to a critical need to maximize the operational cost-efficiency of these units. Several key factors can affect the cost-efficiency of an endoscopy unit, and the 4 key areas discussed in this article are managing capital costs, efficient use of disposables, improving unit efficiency, and creating a positive culture and establishing strong unit leadership. Areas on which to focus to achieve the greatest results will vary based on specific unit characteristics, but initial efforts should aim to improve operations by focusing on 1 to 2 key areas that ideally have been identified by an internal needs assessment...

BACKGROUND : A significant proportion of duodenoscope-transmitted infections have resulted from errors related to reprocessing. Remote video auditing (RVA) is a tool that can monitor reprocessing compliance but it has not been previously evaluated in a tertiary care setting. The aims of this study were to evaluate: 1) RVA feasibility in a tertiary care setting (defined as the ability to audit every step of duodenoscope reprocessing without delaying the next procedure due to unavailability of duodenoscopes); and 2) the use of RVA as a compliance monitoring tool...

Introduction: Efficient and accurate triage of endoscopy referrals is essential. Many of the decisions made are based on national and local triage criteria. Standardizing this approach for nurse use could maintain quality, address clinical risk and significantly improve resource utilization. Aims: This study aimed to compare gastroenterologist and nurse triage of unselected gastroenterology referrals in order to evaluate the proportion of referrals felt able to be triaged to endoscopy and the inter-rater agreement between a triage gastroenterologist and endoscopy nurses for clinical triage decisions regarding the urgency of gastroscopy and colonoscopy...

INTRODUCTION: Oesophageal and gastric cancer is common. Despite advances in investigation and treatment, the outcomes from these cancers remain poor. As part of the Be Clear On Cancer Campaign, the Department of Health runs the National Oesophagogastric Cancer Campaign each year, with key messages of (1) 'Having heartburn most days, for 3 weeks or more could be a sign of cancer' and (2) 'if food is sticking when you swallow, tell your doctor'. METHODS: We evaluated the effect of the National Oesophagogastric Cancer Campaign in our locality...

Background and study aims: The projected increased demand for health services obligates healthcare organizations to operate efficiently. Discrete event simulation (DES) is a modeling method that allows for optimization of systems through virtual testing of different configurations before implementation. The objective of this study was to identify strategies to improve the daily efficiencies of an endoscopy center with the use of DES. Methods: We built a DES model of a five procedure room endoscopy unit at a tertiary-care university medical center...

The purpose of this study is to validate a Jacobian-based iterative method for real-time localization of magnetically controlled endoscopic capsules. The proposed approach applies finite-element solutions to the magnetic field problem and least-squares interpolations to obtain closed-form and fast estimates of the magnetic field. By defining a closed-form expression for the Jacobian of the magnetic field relative to changes in the capsule pose, we are able to obtain an iterative localization at a faster computational time when compared with prior works, without suffering from the inaccuracies stemming from dipole assumptions...

BACKGROUND AND AIMS: There a shortage of robust information about profiles of gastrointestinal disease in sub-Saharan Africa. The endoscopy unit of the University Teaching Hospital in Lusaka has been running without interruption since 1977 and this 38-year record is largely intact. We report an analysis of endoscopic findings over this period. METHODS: Written endoscopy records from 29th September 1977 to 16th December 2014 were recovered, computerised, coded by two experienced endoscopists and analysed...

We present a 74-year-old woman, who developed massive haematemesis and hypovolaemic shock. Her management was challenging, as the bleeding site could not be identified during oesophagogastroduodenoscopy, she was not fit for a general anaesthesia and not able to lie flat due to heart failure, caused by pericardial effusion. She underwent an emergency laparotomy and gastrotomy under a combined thoracic epidural and lumbar spinal regional anaesthesia in a sitting position, 45° to horizontal plane. The bleeding site was identified as a Dieulafoy lesion on the posterior wall of the stomach and was controlled by under running the lesion...

In spite of the economic development through the past six decades post-independence, nearly 70% of the Indian population still live in villages, and these people very often have limited access to the advanced health-care technology. In an attempt to render cost-effective gastrointestinal care to the rural dwellers, we have initiated a Rural Health Care Project. We have tailor-made and converted a bus into a mobile hospital equipped with basic diagnostic facilities including a custom-made endoscopy unit. This bus travels to rural areas and renders basic diagnostic and therapeutic services including endoscopy...

We investigated the microbial contamination of suction tubes attached to wall-type suction instruments. Microbial contamination of suction tubes used for endoscopy or sputum suction in hospital wards was examined before and after their disinfection. In addition, disinfection and washing methods for suction tubes were evaluated. Suction tubes (n=33) before disinfection were contaminated with 10(2)-10(8) colony-forming units (cfu)/tube. The main contaminants were Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia...

BACKGROUND The endoscopy unit before remediation may be a high-risk area for slip and fall injuries due to a large number of exposed above-the-floor wires in the endoscopy rooms, dimmed lighting during endoscopic procedures, and staff inattention to obstacles due to preoccupation with the endoscopic patient. AIM To describe a novel, previously unappreciated workplace hazard to endoscopic personnel: Exposed wires in the endoscopy unit.METHODS This study is a retrospective review of 110,000 endoscopic procedures performed during the last 5 years at an academic, teaching hospital with a high-volume endoscopy unit...

AIM: The increase in the average life led an increase of diseases, acute and chronic, not only cardiovascular and respiratory system, but also gastrointestinal. Likewise we see an increase in neoplastic lesions, sometimes diagnosed in advanced stage of disease, not susceptible to radical therapy. The purpose of this work is to evaluate the usefulness, reliability and security of colonoscopy in elderly patients, age 75 years or more. MATHERIALS END METHODS: We analysed 2407 colonoscopies, performed from January 2005 to December 2006 in Unit of Digestive Endoscopy of Gastrointestinal Surgery ("Federico II" University of Naples) and in Unit of Digestive Endoscopy of "Villa Maria Clinica" (Mirabella Eclano)...

BACKGROUND: Autopsy studies confirm that many intensive care unit (ICU) patients die from unrecognized sources of abdominal sepsis or ischemia. Computed tomography (CT) scans can be of limited use for these diagnoses and difficult to obtain in critically ill patients who require significant support for transport. Bedside laparoscopy has been described but still is cumbersome to perform. Bedside flexible endoscopy as a diagnostic tool or for placement of gastrostomy tubes is a standard ICU procedure...

In August 2001 the Mater Hospital in Belfast opened a new day procedures unit. The unit comprises an admissions area, two theatres, an endoscopy suite and a 23-bed ward, with one theatre almost solely dedicated to ophthalmic surgery. There are three consultant ophthalmologists who currently perform cataract, orbital, corneal, vitreoretinal and plastic surgery on a regular basis. In the four years that the unit has been running we have had a 57% increase in ophthalmic day case surgery.

The telementoring of surgical procedures is currently achieved via a wired infrastructure that usually requires sophisticated videoconference systems. This project represents the first step in assessing the potential for using handheld computers as a mobile alternative to current telementoring systems. Specifically, this project compares a handheld computer to a standard CRT monitor regarding their capability to accurately display video images from an endoscopic procedure. Video images from two previously recorded endoscopic procedures were transmitted from a standard VCR to: 1) a handheld computer (iPAQ 3670 running Pocket PC) via a wireless LAN and 2) a standard CRT monitor via a wired analog connection...

HYPOTHESES: Task performance improves with the use of a balanced degree of shadow and illumination compared with no or maximum shadow contrast; and overhead shadow-casting illumination is better than side illumination. DESIGN: The standard task entailed touching target points on an undulating surface by using a surgical hook. Each run consisted of 13 target points in a random sequence. Five settings were investigated: no shadow; 22%, 42%, and 65% shadow contrast created by overhead illumination; and 22% shadow contrast produced by side illumination...