A new simple technique for performing intraoperative endoscopic resection of small-bowel polyps in patients with Peutz-Jeghers syndrome.
We describe herein a simple method for performing intraoperative endoscopic resection of small-bowel polyps associated with Peutz-Jeghers syndrome, using a corrugated anesthetic tube. A 34-year-old man with Peutz-Jeghers syndrome underwent emergency surgery for an ileo-ileo-colic intussusception. A sterile corrugated anesthetic tube was inserted into the small-bowel, proximal to the affected lesion. The small bowel was then telescoped sequentially over the tube using a pleating technique. Consequently, a colonoscope inserted through the tube was easily able to reach the duodeno-jejunal junction, and ten small-bowel polyps were removed using a wire snare and electrocauterization. All resected specimens were washed out by the instillation of saline through a nasogastric tube, then collected on gauze placed near the outlet of the tube. Our technique has the following merits: it is feasible even in emergency surgery; it prevents contamination of the surgical field; and it facilitates the easy collection of polypectomized specimens.
Ishida
H
H
Department of Surgery, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan.
Murata
N
N
Tada
M
M
Takada
S
S
Fujioka
M
M
Idezuki
Y
Y
D000328:Adult; D004386:Duodenum / Q000601:surgery*; D004564:Electrocoagulation; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D007443:Intussusception / Q000601:surgery; D007583:Jejunum / Q000601:surgery*; D008297:Male; D010580:Peutz-Jeghers Syndrome / Q000601:surgery*