Minimally invasive surgery using intraoperative real-time capsule endoscopy for small bowel lesions

Kazuki Yamashita, Hideo Okumura, Yasuo Oka, Atsushi Urakami, Akiko Shiotani, Hiroshi Nakashima, Hideo Matsumoto, Toshihiro Hirai, Masafumi Nakamura

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The small bowel has been considered the "black box" of gastroenterology. Identifying the exact site of small bowel hemorrhage is often difficult, thus complicating surgical treatment. We report two cases of small bowel bleeding lesions that were successfully managed by intraoperative real-time capsule endoscopy and minimally invasive surgery. Methods: We developed a double-lumen tube similar to, but thinner and longer than, the Miller-Abbott tube. We insert the tube nasally, 3 or 4 days preoperatively, such that its balloon tip reaches the anus by the operative day. During surgery, the endoscopic capsule is connected to the balloon tip of the tube that protrudes from the anus. An assistant pulls on the nasal end of the tube, bringing the balloon tip and capsule back into the bowel. Capsule endoscopic images are displayed in a real-time video format. Results: We employed this procedure in two patients with repeated melena. Various examinations including gastroendoscopy and total colonoscopy showed bleeding confined to the small bowel, but the exact lesion site was unknown. Minimally invasive surgery was successfully performed in both patients: open minilaparotomy in one and laparoscopy in the other. The small bowel and capsule endoscope were easily controlled during minilaparotomy, and real-time capsule endoscopic images clearly identified the bleeding lesion. Control of the small bowel was more difficult in the laparoscopic case; however, real-time capsule endoscopic images identified a small tumor that was successfully resected. Conclusions: Intraoperative capsule endoscopy combined with the tube provides surgeons real-time images indicating the exact site of lesions. The tube also helps surgeons control the position of the capsule endoscope and enables suction of intraluminal fluid or inflation of the lumen to allow clearer views during the operation. We conclude that combined use of capsule endoscopy and the tube facilitates management of bleeding lesions in the small bowel.

Original languageEnglish
Pages (from-to)2337-2341
Number of pages5
JournalSurgical endoscopy
Volume27
Issue number7
DOIs
Publication statusPublished - Jan 1 2013
Externally publishedYes

Fingerprint

Capsule Endoscopy
Minimally Invasive Surgical Procedures
Capsules
Hemorrhage
Capsule Endoscopes
Anal Canal
Laparotomy
Melena
Economic Inflation
Suction
Gastroenterology
Colonoscopy
Nose
Laparoscopy
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Minimally invasive surgery using intraoperative real-time capsule endoscopy for small bowel lesions. / Yamashita, Kazuki; Okumura, Hideo; Oka, Yasuo; Urakami, Atsushi; Shiotani, Akiko; Nakashima, Hiroshi; Matsumoto, Hideo; Hirai, Toshihiro; Nakamura, Masafumi.

In: Surgical endoscopy, Vol. 27, No. 7, 01.01.2013, p. 2337-2341.

Research output: Contribution to journalArticle

Yamashita, K, Okumura, H, Oka, Y, Urakami, A, Shiotani, A, Nakashima, H, Matsumoto, H, Hirai, T & Nakamura, M 2013, 'Minimally invasive surgery using intraoperative real-time capsule endoscopy for small bowel lesions', Surgical endoscopy, vol. 27, no. 7, pp. 2337-2341. https://doi.org/10.1007/s00464-012-2777-3
Yamashita, Kazuki ; Okumura, Hideo ; Oka, Yasuo ; Urakami, Atsushi ; Shiotani, Akiko ; Nakashima, Hiroshi ; Matsumoto, Hideo ; Hirai, Toshihiro ; Nakamura, Masafumi. / Minimally invasive surgery using intraoperative real-time capsule endoscopy for small bowel lesions. In: Surgical endoscopy. 2013 ; Vol. 27, No. 7. pp. 2337-2341.
@article{20c204d00d584f49904ba6fd31d7b0e5,
title = "Minimally invasive surgery using intraoperative real-time capsule endoscopy for small bowel lesions",
abstract = "Background: The small bowel has been considered the {"}black box{"} of gastroenterology. Identifying the exact site of small bowel hemorrhage is often difficult, thus complicating surgical treatment. We report two cases of small bowel bleeding lesions that were successfully managed by intraoperative real-time capsule endoscopy and minimally invasive surgery. Methods: We developed a double-lumen tube similar to, but thinner and longer than, the Miller-Abbott tube. We insert the tube nasally, 3 or 4 days preoperatively, such that its balloon tip reaches the anus by the operative day. During surgery, the endoscopic capsule is connected to the balloon tip of the tube that protrudes from the anus. An assistant pulls on the nasal end of the tube, bringing the balloon tip and capsule back into the bowel. Capsule endoscopic images are displayed in a real-time video format. Results: We employed this procedure in two patients with repeated melena. Various examinations including gastroendoscopy and total colonoscopy showed bleeding confined to the small bowel, but the exact lesion site was unknown. Minimally invasive surgery was successfully performed in both patients: open minilaparotomy in one and laparoscopy in the other. The small bowel and capsule endoscope were easily controlled during minilaparotomy, and real-time capsule endoscopic images clearly identified the bleeding lesion. Control of the small bowel was more difficult in the laparoscopic case; however, real-time capsule endoscopic images identified a small tumor that was successfully resected. Conclusions: Intraoperative capsule endoscopy combined with the tube provides surgeons real-time images indicating the exact site of lesions. The tube also helps surgeons control the position of the capsule endoscope and enables suction of intraluminal fluid or inflation of the lumen to allow clearer views during the operation. We conclude that combined use of capsule endoscopy and the tube facilitates management of bleeding lesions in the small bowel.",
author = "Kazuki Yamashita and Hideo Okumura and Yasuo Oka and Atsushi Urakami and Akiko Shiotani and Hiroshi Nakashima and Hideo Matsumoto and Toshihiro Hirai and Masafumi Nakamura",
year = "2013",
month = "1",
day = "1",
doi = "10.1007/s00464-012-2777-3",
language = "English",
volume = "27",
pages = "2337--2341",
journal = "Surgical Endoscopy",
issn = "0930-2794",
publisher = "Springer New York",
number = "7",

}

TY - JOUR

T1 - Minimally invasive surgery using intraoperative real-time capsule endoscopy for small bowel lesions

AU - Yamashita, Kazuki

AU - Okumura, Hideo

AU - Oka, Yasuo

AU - Urakami, Atsushi

AU - Shiotani, Akiko

AU - Nakashima, Hiroshi

AU - Matsumoto, Hideo

AU - Hirai, Toshihiro

AU - Nakamura, Masafumi

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Background: The small bowel has been considered the "black box" of gastroenterology. Identifying the exact site of small bowel hemorrhage is often difficult, thus complicating surgical treatment. We report two cases of small bowel bleeding lesions that were successfully managed by intraoperative real-time capsule endoscopy and minimally invasive surgery. Methods: We developed a double-lumen tube similar to, but thinner and longer than, the Miller-Abbott tube. We insert the tube nasally, 3 or 4 days preoperatively, such that its balloon tip reaches the anus by the operative day. During surgery, the endoscopic capsule is connected to the balloon tip of the tube that protrudes from the anus. An assistant pulls on the nasal end of the tube, bringing the balloon tip and capsule back into the bowel. Capsule endoscopic images are displayed in a real-time video format. Results: We employed this procedure in two patients with repeated melena. Various examinations including gastroendoscopy and total colonoscopy showed bleeding confined to the small bowel, but the exact lesion site was unknown. Minimally invasive surgery was successfully performed in both patients: open minilaparotomy in one and laparoscopy in the other. The small bowel and capsule endoscope were easily controlled during minilaparotomy, and real-time capsule endoscopic images clearly identified the bleeding lesion. Control of the small bowel was more difficult in the laparoscopic case; however, real-time capsule endoscopic images identified a small tumor that was successfully resected. Conclusions: Intraoperative capsule endoscopy combined with the tube provides surgeons real-time images indicating the exact site of lesions. The tube also helps surgeons control the position of the capsule endoscope and enables suction of intraluminal fluid or inflation of the lumen to allow clearer views during the operation. We conclude that combined use of capsule endoscopy and the tube facilitates management of bleeding lesions in the small bowel.

AB - Background: The small bowel has been considered the "black box" of gastroenterology. Identifying the exact site of small bowel hemorrhage is often difficult, thus complicating surgical treatment. We report two cases of small bowel bleeding lesions that were successfully managed by intraoperative real-time capsule endoscopy and minimally invasive surgery. Methods: We developed a double-lumen tube similar to, but thinner and longer than, the Miller-Abbott tube. We insert the tube nasally, 3 or 4 days preoperatively, such that its balloon tip reaches the anus by the operative day. During surgery, the endoscopic capsule is connected to the balloon tip of the tube that protrudes from the anus. An assistant pulls on the nasal end of the tube, bringing the balloon tip and capsule back into the bowel. Capsule endoscopic images are displayed in a real-time video format. Results: We employed this procedure in two patients with repeated melena. Various examinations including gastroendoscopy and total colonoscopy showed bleeding confined to the small bowel, but the exact lesion site was unknown. Minimally invasive surgery was successfully performed in both patients: open minilaparotomy in one and laparoscopy in the other. The small bowel and capsule endoscope were easily controlled during minilaparotomy, and real-time capsule endoscopic images clearly identified the bleeding lesion. Control of the small bowel was more difficult in the laparoscopic case; however, real-time capsule endoscopic images identified a small tumor that was successfully resected. Conclusions: Intraoperative capsule endoscopy combined with the tube provides surgeons real-time images indicating the exact site of lesions. The tube also helps surgeons control the position of the capsule endoscope and enables suction of intraluminal fluid or inflation of the lumen to allow clearer views during the operation. We conclude that combined use of capsule endoscopy and the tube facilitates management of bleeding lesions in the small bowel.

UR - http://www.scopus.com/inward/record.url?scp=84884907638&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884907638&partnerID=8YFLogxK

U2 - 10.1007/s00464-012-2777-3

DO - 10.1007/s00464-012-2777-3

M3 - Article

VL - 27

SP - 2337

EP - 2341

JO - Surgical Endoscopy

JF - Surgical Endoscopy

SN - 0930-2794

IS - 7

ER -