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1.
Artigo em Inglês | MEDLINE | ID: mdl-33809670

RESUMO

Endoscopes are medical instruments that are used routinely in health structures. Due to their invasive nature and contact with many patients, they may cause hospital-acquired infections if not disinfected correctly. To ensure a high-level disinfection procedure or reprocessing, since the methods currently adopted in our institute are adequate, we evaluated retrospectively the presence of microorganisms in our endoscopes after reprocessing. Microbiological surveillance was performed from January 2016 to December 2019 in the instruments in use in our endoscopic room after reprocessing. In total, 35 endoscopes (3 duodenoscopes, 3 echoendoscopes, 12 bronchoscopes, 5 colonoscopes, and 12 gastroscopes) were evaluated for the presence of microorganisms, including multidrug-resistant pathogens and indicator microorganisms (IMOs). Our procedures were in agreement with an internal protocol based on Italian, international, and the Center for Disease Control and Prevention (CDC) recommendations. Of a total of 811 samples, 799 (98.5%) complied with the regulatory guidelines, while 9 (1.1%) were positive for IMOs, and 3 (0.4%) displayed more than 10 colony-forming units (CFU) of environmental and commensal pathogens. Our results show that the internal reprocessing protocol is very efficient, leading to a very low number of observed contaminations, and it could be easily implemented by other health facilities that face a huge number of hospital-acquired infections due to incorrectly disinfected endoscopes.


Assuntos
Endoscópios , Reutilização de Equipamento , Desinfecção , Contaminação de Equipamentos , Hospitais , Humanos , Itália/epidemiologia , Estudos Retrospectivos
2.
Artigo em Inglês | MEDLINE | ID: mdl-33802350

RESUMO

Background: Failure in the reprocessing of thermolabile flexible endoscopes has been reported as one of the most important threats to patient health. Method: A case report and observational study was conducted, from August 2014 to December 2019, in the Digestive Endoscopy Unit of a University Hospital in Italy, where two cases of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae infections in patients undergoing endoscopic retrograde cholangio-pancreatography were observed. Following the risk/safety management practices, an epidemiological investigation was started, duodenoscopes were removed from use and the reprocessing practices reviewed. Moreover, microbiological surveillance of endoscopes was carried out according to the CDC guidelines. Results: In the first phase of sampling, 10/10 (100%) endoscopes were found to be non-compliant, of which 7 showed results for high-concern organisms (HCOs), such as KPC-K. pneumoniae, P. aeruginosa and E. coli. After implementing corrective actions, 12 out of 17 endoscopes were found to be non-compliant (70.5%), of which 8 showed results for HCOs, such as KPC-K. oxytoca and P. aeruginosa. During the last year of regular microbiological surveillance, only 23% of endoscopes (35/152) were found to be non-compliant, of which 7 showed results for HCOs, such as NDM-K. pneumoniae, P. aeruginosa and A. baumannii. The crucial issues were related to samples collected from the internal channels of duodenoscopes. Conclusion: Managing the risk associated with the reprocessing of digestive endoscopes, through risk assessment at every stage of the process, is important for the prevention of infections associated with the use of these device.


Assuntos
Contaminação de Equipamentos , Escherichia coli , Desinfecção , Duodenoscópios , Endoscópios , Contaminação de Equipamentos/prevenção & controle , Humanos , Itália
4.
Artigo em Chinês | MEDLINE | ID: mdl-33794602

RESUMO

Objective:To summarize and analyze the feasibility, safety and efficacy of parapharyngeal space surgery assisted by coblation and endoscopic system with transoral approach. Methods:The data of 20 patients with parapharyngeal space tumors were retrospectively analyzed. All the patients underwent CT and/or MRI examination before surgery, and all underwent transoral approach assisted by coblation and endoscopic systems. The patients were followed up strictly after the operation, with a follow-up time of 8-56 months and the median follow-up time of 28 months. Results:Among the 20 patients, 18 (90%) were pathologically benign tumors and 2 (10%) were malignant tumors. The maximum tumor diameter was (4.4±1.6) cm, the operative time was (79.00±30.03) min, the intraoperative blood loss was (23.63±22.20) mL, and the postoperative pain VAS score was 2.8±1.4. There were 17 cases complete resection, and 3 cases of relapse, including 1 patient who died after distant metastasis of synovial sarcoma postoperative complications occurred in 2 cases, hoarseness in 1 case of neurofibroma and tongue extension deflection in 1 case of schwannoma. Conclusion:Coblation assisted endoscopic system for the treatment of parapharyngeal space tumors with transoral approach has no cervical scar, which is a satisfaction for the patients, less intraoperative bleeding, short operative time, mild postoperative reaction and quick recovery. However, external approach is still recommended for primary malignant lesions, extensive or highly vascularized lesions, tumors located on the lateral side of the internal carotid artery, less than 2 cm from the skull base, or lateral invasion of the deep lobe of the parotid gland, or a pleomorphic adenoma is considered or is found to be too large to be completely resected preoperatively or intraoperatively.


Assuntos
Adenoma Pleomorfo , Neoplasias Faríngeas , Endoscópios , Humanos , Espaço Parafaríngeo , Neoplasias Faríngeas/cirurgia , Estudos Retrospectivos
5.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(2): 153-158, 2021 Apr 08.
Artigo em Chinês | MEDLINE | ID: mdl-33825373

RESUMO

Electronic endoscope is one of the crucial tools for minimally invasive diagnosis and treatment. Along with the continuous development of clinical applications, conventional electronic endoscope has not been able to meet all the clinical requirements. In recent years, with the rapid development of the material, sensor and electronic technologies, electronic endoscope has attracted many researchers and companies' attention. Nowadays, because of being suitable for some special mobile medical scenes like field operations, natural calamities and hospital first aids, various portable electronic endoscopes have been developed and applied in clinic. The present study aims to give a review on portable electronic endoscopes development and clinical applications.


Assuntos
Eletrônica , Endoscópios
7.
Endoscopy ; 53(4): 456, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33780984
8.
Int J Oral Maxillofac Implants ; 36(1): 137-145, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600535

RESUMO

PURPOSE: To evaluate the clinical and radiographic outcomes of endoscope-assisted maxillary sinus floor elevation with platelet-rich fibrin grafting and simultaneous implant placement (PESS) in atrophic maxillae. MATERIALS AND METHODS: Twenty-three implants were placed to rehabilitate atrophic maxillae. Patient satisfaction was measured with a visual analog scale (VASpain). CBCT was taken to assess the bone changes for the elevated sites. RESULTS: Twenty-two of 23 implants fulfilling the survival criteria represented a 1-year survival rate of 95.65%. The VASpain score decreased with time. The residual bone height was 4.45 ± 1.44 mm. The elevation height was 6.72 ± 1.84 mm. The definitive restoration was completed in the 4th month postsurgery. The peri-implant bone level value was 6.04 ± 2.30 mm, 6.32 ± 2.25 mm, and 6.71 ± 1.97 mm at the 3rd, 9th, and 15th month postsurgery. The crestal bone level value decreased by 0.22 ± 0.56 mm from the 3rd month to the 15th month postsurgery (P > .05). Bone mineral density increased with time at the neck, middle, and root site of implant. CONCLUSION: PESS in the maxilla resulted in predictable peri-implant bone formation. This strategy is a relatively safe and effective approach with less invasion, which provides new insights into the choice of implant treatment plans.


Assuntos
Implantes Dentários , Fibrina Rica em Plaquetas , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Endoscópios , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Estudos Prospectivos , Resultado do Tratamento
9.
Otol Neurotol ; 42(2): e172-e176, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33443357

RESUMO

OBJECTIVES: Assess the clinical utility of an Endoscopic Integrated Multipoint Laser System (EMLS) to otology. This is an emerging technology from automotive engineering that may offer the ability to accurately measure anatomy and pathology using an endoscope while undertaking ear surgery. PATIENTS: Simulated otology patients were used incorporating the Phacon Temporal Bone synthetic models and Kyoto Kagaku Ear Examination Simulator models to allow assessment of the EMLS technology in evaluating external ear and middle ear pathology, e.g., perforation or prosthesis sizing. INTERVENTION: Eight otolaryngology resident and fellows at a tertiary university teaching hospital were given training in EMLS and reviewed simulated anatomy and pathology within the models including tympanic membrane perforation, ossicular discontinuity, and a cochleostomy. MAIN OUTCOME MEASURE: Variance in measurement was assessed in relation to those made manually by an independent surgeon using surgical calipers (0.1 mm). RESULTS: The 8 participants produced 47 mean measurements. The mean difference from independently made manual measurement was 0.294 mm (standard error of the mean 0.033). Maximum variance was 0.98 mm and minimum 0.01 mm. CONCLUSION: Use of an integrated endoscopic laser measurement tool allows reliable, easy-to-obtain measurements to be obtained within a simulated otological surgical environment. Translation of the technology to a thinner delivery system through a rigid endoscope offers further promise for routine use in a clinical setting.


Assuntos
Procedimentos Cirúrgicos Otológicos , Orelha Média , Endoscópios , Endoscopia , Humanos , Lasers
10.
Eur Arch Otorhinolaryngol ; 278(4): 1283-1288, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33439340

RESUMO

BACKGROUND: 30° and 45° endoscopes are commonly used, but there are few reports about the use of 70° endoscopes for ear surgery. METHODS: The use of 70° endoscopes made it possible to resect cholesteatomas without removing extensive regions of the external ear canal, which facilitated reconstruction, as the areas that needed to be reconstructed were smaller. CONCLUSION: None of the 34 patients who underwent this procedure for pars flaccida cholesteatoma suffered recurrence. Therefore, we consider that the procedure is useful. A further study of the postoperative outcomes of this procedure should be conducted.


Assuntos
Colesteatoma da Orelha Média , Colesteatoma , Procedimentos Cirúrgicos Otológicos , Colesteatoma/cirurgia , Colesteatoma da Orelha Média/cirurgia , Meato Acústico Externo/cirurgia , Endoscópios , Humanos , Membrana Timpânica
11.
HNO ; 69(3): 239-246, 2021 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-33502577

RESUMO

There is plethora of treatment options for surgeons dealing with salivary stones. During recent decades, emphasis has been laid on gland-preserving minimally invasive techniques for stone removal. In this context, visualization of salivary ducts with semirigid endoscopes for diagnostic and therapeutic purposes, the so-called sialendoscopy, has become increasingly important. This article gives an overview of indications for sialendoscopy and how the procedure is performed. Furthermore, sialendoscopy is discussed in the context of other modalities for salivary stone treatment.


Assuntos
Endoscopia , Cálculos das Glândulas Salivares , Endoscópios , Humanos , Estudos Retrospectivos , Ductos Salivares , Cálculos das Glândulas Salivares/diagnóstico por imagem , Cálculos das Glândulas Salivares/cirurgia , Resultado do Tratamento
12.
Adv Exp Med Biol ; 1293: 471-479, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33398834

RESUMO

To elucidate the expression mechanisms of brain functions, we have developed an ultrathin fluorescence endoscope imaging system (U-FEIS) that can image cells in the brain at any depth while minimizing the invasion. The endoscope part of U-FEIS consists of a GRIN lens and a 10,000-pixel image fiber with a diameter of 450 µm. The specialized microscope of U-FEIS is within 30 cm square and includes lenses and optical filters optimized for the endoscope. Using U-FEIS, we successfully visualized neurons expressing GFP with single-cell resolution and recorded the multineuronal activities in vitro and in vivo. U-FEIS can also perform imaging and optical stimulation simultaneously. Therefore, U-FEIS should be a powerful optical tool in neuroscience research.


Assuntos
Endoscópios , Lentes , Encéfalo/diagnóstico por imagem , Neuroimagem Funcional , Microscopia
13.
Otolaryngol Clin North Am ; 54(1): 11-23, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33243372

RESUMO

A new era of surgical visualization and magnification is poised to disrupt the field of otology and neurotology. The once revolutionary benefits of the binocular microscope now are shared with rigid endoscopes and exoscopes. These 2 modalities are complementary. The endoscope improves visualization of the hidden recesses through the external auditory canal or canal-up mastoidectomy. The exoscope provides an immersive visual experience and superior ergonomics compared with binocular microscopy. Endoscopes and exoscopes are poised to disrupt the standard of care for surgical visualization and magnification in otology and neurotology.


Assuntos
Endoscópios/normas , Endoscopia/instrumentação , Neuro-Otologia/instrumentação , Otolaringologia/instrumentação , Pandemias , Meato Acústico Externo/cirurgia , Endoscopia/normas , Desenho de Equipamento/normas , Humanos , Mastoidectomia/instrumentação , Microcirurgia/instrumentação , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Procedimentos Neurocirúrgicos/instrumentação , Neuro-Otologia/normas , Otolaringologia/normas , Padrão de Cuidado/normas , Estados Unidos
14.
Int J Mol Sci ; 21(24)2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33317217

RESUMO

In this study, in vivo animal experiments with 12 nude mice bearing breast-cancer-patient-tissue-derived xenograft (PDX) tumors were performed aiming to verify the imaging capability of a novel miniaturized fluorescence molecular tomography (FMT) endoscope, in combination with targeted nanoparticle-near-infrared (NIR) dye conjugates. Tumor-bearing mice were divided into two groups by systematic injection with urokinase plasminogen activator receptor-targeted (n = 7) and nontargeted (n = 5) imaging nanoprobes as a contrast agent, respectively. Each mouse was imaged at 6, 24, and 48 h following the injection of nanoprobes using the FMT endoscope. The results show that systemic delivery of targeted nanoprobes produced a 4-fold enhancement in fluorescence signals from tumors, compared with tumors that received nontargeted nanoprobes. This study indicates that our miniaturized FMT endoscope, coupled with the targeted nanoparticle-NIR dye conjugates as a contrast agent, has high sensitivity and specificity, and thus great potential to be used for image-guided detection and removal of a primary tumor and local metastatic tumors during surgery.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Endoscópios/normas , Nanopartículas/química , Tomografia Óptica/instrumentação , Animais , Neoplasias da Mama/metabolismo , Endoscopia/instrumentação , Endoscopia/métodos , Feminino , Corantes Fluorescentes/química , Humanos , Camundongos , Camundongos Nus , Miniaturização , Nanoconjugados/química , Nanopartículas/metabolismo , Receptores de Ativador de Plasminogênio Tipo Uroquinase/metabolismo , Tomografia Óptica/métodos , Células Tumorais Cultivadas
15.
Acta Cir Bras ; 35(11): e351104, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33331454

RESUMO

PURPOSE: To develop a simpler animal model for benign tracheal stenosis and introduce a low-cost household endoscope for postmodeling endotracheal evaluation. METHODS: Twenty rabbits were randomly divided into a model group (15 rabbits, subjected to transoral nylon brush scraping of the trachea) and a mock group (5 rabbits, merely exempted from scraping), a household endoscope was then introduced for weekly endoscopic examination. Meanwhile, other 15 rabbits (modeling like the model group) underwent batch tracheal resection at different postintervention times for pathological analysis. RESULTS: The model group presented a low mortality and few complications. The endoscope could obtain adequate images for stenosis assessment, which showed that the models presented homogeneous injury after scraping and developed a mature scar stricture at 28 days postoperatively with a mean stenosis degree of 65.9%, and 71.4% (10/14) above Myer-Cotton's grade II. The pathological findings were consistent with the clinicopathological process of human. No stenosis was found in mock group. CONCLUSION: The modified model is simpler, minimally invasive and reliable, while the household endoscope is competent for model's follow-up, providing easily accessible and useful tools for facilitating more extensive studies of benign tracheal stenosis.


Assuntos
Estenose Traqueal , Animais , Modelos Animais de Doenças , Endoscópios , Endoscopia , Coelhos , Traqueia/cirurgia , Estenose Traqueal/cirurgia
16.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 897-901, 2020 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-33171565

RESUMO

Objective: To observe the status of the sinus membrane using fiber optic endoscope during the lateral window approach sinus floor elevation to provide a reference for clinicians when evelvating the sinus mucoperiosteum. Methods: Sixty-six patients (72 sides) who underwent maxillary sinus floor elevation in Beijing Ruicheng Stomatology Hospital from September 2016 to December 2019 were selected, including 40 males and 26 females, aged 26-80 years old [(56.2±11.5) years]. And fiber optic endoscopy was used to observe the maxillary mucoperiosteum during the operation. Results: The status of maxillary sinus mucoperiosteal during lateral window approach sinus floor elevation can be divided into four categories: ① Class Ⅰ, complete periosteal, no damage to mucoperiosteum; ②Class Ⅱ, periosteal injury, unexposed laminae propria; ③Class Ⅲ, periosteal Rupture, exposed lamina propria; ④ Class Ⅳ, mucoperiosteum perforation, rupture of periosteum, lamina propria and epithelial layer. A total of 72 operations were performed, including 18 cases of class I, 28 cases of class Ⅱ, 4 cases of class Ⅲ, and 22 cases of class Ⅳ. Conclusions: The status of maxillary sinus mucoperiosteal during lateral window approach sinus floor elevation can be divided into four categories. Fiberoptic endoscopy as a clinical auxiliary examination method can improve the operator's control of the status of the maxillary sinus membrane and assist the peeling of the mucosa.


Assuntos
Seio Maxilar , Levantamento do Assoalho do Seio Maxilar , Adulto , Idoso , Idoso de 80 Anos ou mais , Endoscópios , Feminino , Humanos , Masculino , Maxila , Seio Maxilar/cirurgia , Pessoa de Meia-Idade , Mucosa Nasal
17.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 34(9): 824-827;835, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-33040508

RESUMO

Objective:To evaluate the feasibility and safety of the endoscope-assisted transoral approach for the parapharyngeal space(PPS) tumors. Method:This retrospective study included 22 patients who were diagnosed with PPS tumors and treated with the endoscope-assisted transoral approach. Result:The postoperative pathological diagnosis included 10 cases of schwannoma, 7 cases of pleomorphic adenoma, 1 case of paraganglioma, 1 case of branchial cleft cyst, and 3 cases of malignant tumors for a diagnostic purpose. The surgical duration was between 15 minutes and 430 minutes(median duration 105 minutes), and the intraoperative bleeding was between 10ml to 500ml(median bleeding 20 mL). Complete resection with minor complication was performed in 21 cases, 1 case of recurrent schwannoma was done in an incomplete style because of intraoperative massive bleeding. With a 12-to-72-months follow up, there was no relapse on the 18 cases of benign tumor which were completely resected. Conclusion:Endoscope-assisted transoral resection provide cosmetic, micro-invasive and increased operative exposure to the PPS, especially for the benign tumors that medial to the carotid sheath. But is not recommend for relapsed cases and lesions that encompassing or lying posterolateral to the carotid sheath.


Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias Faríngeas , Endoscópios , Humanos , Recidiva Local de Neoplasia , Espaço Parafaríngeo , Neoplasias Faríngeas/cirurgia , Estudos Retrospectivos
19.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4357-4360, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018960

RESUMO

We have developed a series of 3D endoscopic systems where a micro-sized pattern projector is inserted through the instrument channel of the endoscope and shapes are reconstructed by a structured light technique using captured images of the endoscopic camera. One problem of the previous works is that the accuracy of shape reconstruction is low, because the projector cannot be fixed to the endoscope, and thus, the pose of the pattern projector w.r.t. the camera cannot be pre-calibrated. In this paper, we propose a method to auto-calibrate the pose of the projector without using any special devices nor manual process. Since the technique is one-shot, multiple shapes can be reconstructed from an image sequence and a large 3D scene can be recovered by merging them. Experiments are conducted using the real system.


Assuntos
Algoritmos , Imageamento Tridimensional , Endoscópios , Endoscopia , Fotografação
20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4732-4736, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019048

RESUMO

We present a novel method to estimate the 3D pose and curvature of bendable interventional devices using a single X-ray image. A preliminary experiment was performed to demonstrate the feasibility of the proposed method. The mean estimation accuracies were 3.48mm and 0.59mm for the 3D pose and the radius of curvature of the bendable cardiac ablation catheter, respectively. This method has the potential to help clinicians to make a better intraoperative decision during the procedure, resulting in expedite surgery and reduce exposure to ionizing radiation.Clinical relevance- This novel method has the potential to improve clinician's intraoperative decision-making by providing the 3D pose and curvature information of bendable interventional devices, such as flexible catheter and endoscope.


Assuntos
Ablação por Cateter , Endoscópios , Cateteres Cardíacos , Coração , Raios X
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