title: Endoscopic marking: an adjunct to laparoscopic gastrointestinal surgery.
abstract: BACKGROUND
  In 1975 one of us (J.P.) first described endoscopic marking of the intestinal lumen with india ink to produce a serosal tattoo, thus facilitating the location of lesions during subsequent surgery. The use of the technique in concert with laparoscopic surgery is particularly important because the ability to palpate the bowel is lost. Carbon-based products such as india ink provide permanent marking. An alternative marker is methylene blue, whose mark is only temporary but clearly seen laparoscopically.
  
  
  METHODS
  We have used methylene blue for intraoperative marking, reserving India ink for instances in which marking endoscopy occurs before surgery.
  
  
  RESULTS
  15 patients, over a period of 2 years, had endoscopic marking performed preoperatively or intraoperatively. All markings were easily visualized upon laproscopy, assisting identification of the sites of the lesions. Numerous other cases were marked at endoscopy but did not come to surgery.
  
  
  CONCLUSIONS
  Endoscopic marking is an invaluable tool in the performance of laparoscopic gastrointestinal surgery.
authors.affiliation: Division of General Surgery, Saint Louis University, 3635 Vista Avenue, St. Louis, MO 63110, USA.
authors.forename: R I
authors.initials: RI
authors.lastname: Beretvas
authors.forename: J
authors.initials: J
authors.lastname: Ponsky
mesh_terms: D002244:Carbon; D004396:Coloring Agents; D013505:Digestive System Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D008751:Methylene Blue; D013653:Tattooing
chemical_list: D004396:Coloring Agents; C028433:chinese ink; D002244:Carbon; D008751:Methylene Blue