title: Initial evaluation of a novel prototype forward-viewing US endoscope in transmural drainage of pancreatic pseudocysts (with videos).
abstract: BACKGROUND
  Transmural endoscopic drainage has become the treatment of first choice for uncomplicated pseudocysts. Drainage is mostly performed with presently available therapeutic oblique-viewing (45 degrees ) US endoscopes. Puncturing at an angle sometimes hampers successful completion of the procedure, because the force that is applied while introducing instruments through the working channel is not fully exerted at the tip of the accessory but instead drives the endoscope away from the gut wall. A prototype forward-viewing US endoscope was developed to overcome this difficulty.
  
  
  OBJECTIVE
  Evaluation of an initial experience with a novel prototype forward-viewing US endoscope in endoscopic drainage of pancreatic pseudocysts.
  
  
  METHODS
  Retrospective, observational study.
  
  
  METHODS
  Two tertiary-referral centers.
  
  
  METHODS
  Seven patients were treated.
  
  
  METHODS
  Endoscopic drainage of pancreatic pseudocyst with a novel forward-viewing US endoscope.
  
  
  METHODS
  Successful endoscopic drainage.
  
  
  METHODS
  In all cases drainage was successfully performed without complications. In 2 cases, the procedure was initially started with a conventional side-viewing EUS scope, but it proved impossible to puncture the pseudocyst. However, with the use of the forward-viewing EUS scope, both pseudocysts were successfully punctured.
  
  
  CONCLUSIONS
  Small sample size.
  
  
  CONCLUSIONS
  Initial clinical experience with this novel prototype forward-view US endoscope for transmural drainage of pancreatic pseudocyst is favorable. It provides better control during puncturing of the cyst wall and creates a possibility to drain collections that are inaccessible with a conventional therapeutic side-viewing US endoscope.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Rogier P
authors.initials: RP
authors.lastname: Voermans
authors.forename: Pierre
authors.initials: P
authors.lastname: Eisendrath
authors.forename: Marco J
authors.initials: MJ
authors.lastname: Bruno
authors.forename: Olivier
authors.initials: O
authors.lastname: Le Moine
authors.forename: Jacques
authors.initials: J
authors.lastname: Devière
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
mesh_terms: D004322:Drainage / Q000295:instrumentation; D020776:Endoscopes, Gastrointestinal / Q000592:standards*; D016145:Endoscopy, Digestive System; D019160:Endosonography / Q000295:instrumentation*; D006801:Humans; D010192:Pancreatic Pseudocyst / Q000628:therapy*; D012189:Retrospective Studies