Browsing by Subject "colon"

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    Robotic Approach to Colon Resection
    (Elsevier, 2016-09) Waters, Joshua A.; Francone, Todd D.; Department of Surgery, IU School of Medicine
    Robotic surgical techniques are being increasingly adopted as a tool in the minimally invasive armamentarium of the colorectal surgeon. These platforms present numerous potential advantages in visualization, precise dissection, and tissue manipulation while potentially reducing operator fatigue. They may also reduce the learning curve and rate of conversion, though the short- and long-term benefits of this approach in non-pelvic colorectal surgery, and the cost–benefit balance remain an ongoing debate. Adherence to established principles of laparoscopic colon surgery, a robust understanding of the operative anatomy, and proper patient preparation and setup are critical for the efficient and effective utilization of a robotic approach for colon resection.
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    When and How To Use Endoscopic Tattooing in the Colon: An International Delphi Agreement
    (Elsevier, 2021) Medina-Prado, Lucía; Hassan, Cesare; Dekker, Evelien; Bisschops, Raf; Alfieri, Sergio; Bhandari, Pradeep; Bourke, Michael J.; Bravo, Raquel; Bustamante-Balen, Marco; Dominitz, Jason; Ferlitsch, Monika; Fockens, Paul; van Leerdam, Monique; Lieberman, David; Herráiz, Maite; Kahi, Charles; Kaminski, Michal; Matsuda, Takahisa; Moss, Alan; Pellisé, Maria; Pohl, Heiko; Rees, Colin; Rex, Douglas K.; Romero-Simó, Manuel; Rutter, Matthew D.; Sharma, Prateek; Shaukat, Aasma; Thomas-Gibson, Siwan; Valori, Roland; Jover, Rodrigo; Medicine, School of Medicine
    Background & Aims There is a lack of clinical studies to establish indications and methodology for tattooing, therefore technique and practice of tattooing is very variable. We aimed to establish a consensus on the indications and appropriate techniques for colonic tattoo through a modified Delphi process. Methods The baseline questionnaire was classified into 3 areas: where tattooing should not be used (1 domain, 6 questions), where tattooing should be used (4 domains, 20 questions), and how to perform tattooing (1 domain 20 questions). A total of 29 experts participated in the 3 rounds of the Delphi process. Results A total of 15 statements were approved. The statements that achieved the highest agreement were as follows: tattooing should always be used after endoscopic resection of a lesion with suspicion of submucosal invasion (agreement score, 4.59; degree of consensus, 97%). For a colorectal lesion that is left in situ but considered suitable for endoscopic resection, tattooing may be used if the lesion is considered difficult to detect at a subsequent endoscopy (agreement score, 4.62; degree of consensus, 100%). A tattoo should never be injected directly into or underneath a lesion that might be removed endoscopically at a later point in time (agreement score, 4.79; degree of consensus, 97%). Details of the tattoo injection should be stated clearly in the endoscopy report (agreement score, 4.76; degree of consensus, 100%). Conclusions This expert consensus has developed different statements about where tattooing should not be used, when it should be used, and how that should be done.