"Super minimally invasing"! Specialist digestive endoscopy to cut tumors

(Health Times reporter Chen Linhui)
" The ultra-minimally invasive concept is ideal for experts in digestive endoscopy. On
21st, in the office of the Digestive Department of Peking University's Third Hospital, Professor Huang Yonghui looked at the patient's examination report and said that "super-minimally invasive" was the direction and goal of the current field of minimally invasive endoscopic therapy.
traditional surgery or minimally invasive thoracic laparoscopic surgery at the expense of removing all or part of the patient's organs while removing the lesions. "Super minimally invasive" is to remove the patient's early cancer lesions while preserving the integrity of the organs, remove lesions.Professor Huang Yonghui is communicating with patients Chen Linhui / photo
ERCP gallbladder stones
no pain, no itch, no recurrence
in Professor Huang Yonghui's clinic, there are patients from the north of Tiannanhai, they have a common demand: micro-invasion can cure major diseases without a knife.
Wu Bing (analyte) is only 40 years old, but he is a "regular visitor" to the hospital's digestive department.
years ago, because of acute high fever (39.5 degrees), abdominal pain, yellowing of the eyes and skin, deepening the color of urine, the color of the stool became lighter, was rushed to the hospital, after blood pumping, CT, MRCP and a series of detailed examination, and finally found that the gallbladder stone (gallbladder stones) in the "weird."
gallbladder stones clog the bile gallbladder, making bile flow out of the smooth, causing "acute bile tube inflammation." Doctors immediately gave Wu Bing ERCP gallbladder stone surgery, after which the body temperature quickly returned to normal, abdominal pain disappeared, skin, stool, urination color also became normal. Wu Bing was discharged from the hospital and went home.
this, Wu Bing had three more seizures in three years. At the doctor's recommendation, Wu Bing came to Peking University Third Hospital and met Professor Huang Yonghui, an expert in endoscopy.
Professor Huang Yonghui told reporters that in the treatment of bile duct stones under ERCP, in order to be able to successfully remove large stones from the bile ducts, it is necessary to cut open the bile duct opening near the "gatekeeper" role of nipple sphides. This is bound to cause nipple sphides damage, loss of its physiological needs in accordance with the contraction / lysosis, control bile outflow function. This can cause acute bile dulineitis, repeated recurrence of gallbladder stones, bile duly stenosis and a series of complications and follow-up problems.
" endoscopic nipple molding, can ensure the smooth flow of bile under the premise of the use of endoscopic technology, with the 'clip' to cut the nipple sphides for 'stitching', so that the 'doorman' to restore its normal function. Professor Huang Yonghui said while demonstrating that, taking into account the repeated ERCP stone-taking in the past, the destruction of the structure and function of nipple sphides is the "main culprit" for Wu Bing's repeated gallbladder stones attack, and Professor Huang's team developed a new treatment plan for Wu Bing. That is, on the basis of ERCP stone, at the same time carry out "endoscopic nipple molding", "stitching" over-expansion of the heteroscopic nipple sphides.
" currently suitable for patients with bile tube stones who need ERCP stone. "For the new technology, which won the first prize of the 2020 Medical Technology Innovation Award of the Three Hospitals of Northern Medicine, Professor Huang Yonghui said that endoscopic papyridosis can significantly reduce the risk of relapsed gallbladder stones and bile ductitis after ERCP gallbladder surgery, and reduce the risk of complications such as postoperative pancreatitis and postoperative bleeding. By reducing the occurrence of relapsed gallbladder stones, the number of ERCP operations is reduced, patient pain is reduced, and medical costs and resources are saved.
12-finger intestinal nipples are like unresolted
patients wet their eyes after reviewing
and Xiao Wu have a similar situation with 63-year-old Lao Xu. Six months ago, he was diagnosed with acute pus bile ductitis, Professor Huang Yonghui's team in its endoscopic stone, the application of self-created technology to nipple sphides and then carried out a "zip-type" stitching, the results of the review recovered well.
, Mr. Xu came to the emergency department of Peking University's Third Hospital because of high fever, chills and jaundice. At the time of his visit, his body temperature was as high as 39.5 degrees C and biliary erythrin was up to 120umol/L (normal value 17umol/L), and he was diagnosed with acute obstructive pus bile duditis in combination with imaging and other laboratory tests.
, the conventional effective means of solving the disease was to remove the stones in the bile tube using minimally invasible means by endoscopic retrograde pancreatic bile tube erythrology (ERCP) through a tidal intestinal mirror. The advantage of this technology is minimally invasive, patients do not have to bear the risk of surgery, after treatment, quick results, bile flow after infection can be controlled quickly. But to achieve this effect, a key step is the need to cut the sphins of the hetero-fingered breast head and apply a device to "pull" the stone out.
Nipple sphides are an innate physiological barrier between the bile tract and the tigular intestinal cavity, with which the contents of the intestinal cavity will not flow back into the bile gallblades, while the sphides also regulate the outflow of bile and pancreatic fluid, to ensure that the human body can digest food normally.
If it is a conventional surgical ERCP treatment, the nipple sphides will not be able to repair themselves after cutting open, its original physiological function, the long-term adverse effect is due to the presence of the tigular fluid to the bile gallbladder reflow, resulting in bacteria in the gallbladder implantation, accumulation of stones may occur repeatedly, and even the occurrence of bile tube cancer.
"'Endoscopic nipple molding' is after the successful stoneing of conventional ERCP, the use of repetitively opened metal clips will be cut nipple sphides again 'zip-type' stitching, in order to restore its physiological function, to prevent the recurrence of long-term stones. Professor Huang Yonghui gave a detailed introduction to the latest technology of his own innovation, endoscopic nipple molding, and carefully explained the ERCP surgical stone-taking process, possible complications and so on.
, Mr. Xu decided to use ERCP technology to extract stone and try "endoscopic nipple molding". The operation was very successful, and during the six months of follow-up after the operation, a review of the gastroscope revealed that the duotony nipples had fully recovered, the same as the unoptomed state.
it's so easy to have such a big operation! "Old Xu was very happy when he got the results of the review.
super minimally invasive
gave more patients hope
Ms. Li, 65, under a gastroscopy for "swallowing chokes", discovered a huge swelling in her esopterior, 2.5x7cm, which required surgical removal. Patients have been suffering from diabetes, coronary heart disease, stent into surgery, from the field to Beijing.
After being admitted to hospital, Professor Huang Yonghui's team conducted a full preoperative evaluation of Ms. Li, taking into account that the patient is 65 years old, has coronary heart disease, diabetes, esopaedic lesions are huge, if the surgical open chest surgery to remove part of the esophoosis, the risk of surgery is very high, and the wound is large, the postoperative healing is slow. Although there is no manifestation of malignant tumors, regular review with a gastroscope to observe the evolution of the lesions can increase the psychological stress of the patient and is likely to delay treatment.
Professor Huang Yonghui applies a new technique for endoscopic therapy in the digestive department for the characteristics of patients' lesions: endoscopic tunnel tumor excision, i.e., the establishment of a mucous membrane tunnel between the mucous membrane layer and the inherent muscle layer, "drilling" to the lesions under the esoesotic membrane to completely remove the huge swelling.
the operation went smoothly and took only 35 minutes. After the operation, Ms. Li was ready to eat after 4 days, and 7 days later she was discharged from the hospital without any complications, and the postoperative pathological results showed smooth fibroids. The patient's tumor was successfully removed, while solving the hidden dangers, reducing the psychological pressure of the patient, and no need to review the endoscopy.
, surgery to open the chest surgery needs to remove part of the esopaedia, trauma, surgery time is long, high risk. Traditional gastroscopic excision lesions ESD or EMR require lesions that are not suitable for removing the inherent muscle layer, are prone to large perforations, and have the potential to be removed uncleanly. Simply reviewing gastroscopic follow-up on a regular basis can increase the psychological stress of patients and even risk delaying treatment.
" this new technology uses endoscopy to build tunnels under the mucous membrane, reducing the risk of surgery, removing tumors, and avoiding the potential for delayed treatment. Professor Huang Yonghui said that this technique is small in trauma, rapid recovery, in the removal of tumors, to solve health risks at the same time, to avoid long-term endoscopic or other imaging follow-up, reduce mental stress and economic burden, suitable for patients with benign tumors under the esophageal mucosa, benign tumors under the mucosa.
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