Esophageal Case 6
Prof. Philip Chiu
Dept of Surgery, Faculty of Medicine
The Chinese University of Hong Kong
Disclaimer:
- NBI™ and TXI™ Technologies are not intended to replace histopathological sampling as a means of diagnosis
- NBI™ and TXI™ Technologies are 510(k) cleared in the United State. This case study is being furnished to provide example of NBI and TXI technology use. The GIF-EZ1500 used in this case is not available in the US market at this time, nor is there an established time for it’s release. The safety and effectiveness of this product and/or the use of these products has not yet been established in the United States market.
- The positions and statements made herein by Prof. Chiu are based on Prof. Chiu’s experiences, thoughts and opinions. As with any product, results may vary, and the techniques, instruments, and settings can vary from facility to facility. The content hereof should not be considered as a substitute for carefully reading all applicable labeling, including the Instructions for Use. Please thoroughly review the relevant user manual(s) for instructions, risks, warnings, and cautions. Techniques, instruments, and setting can vary from facility to facility. It is the clinician’s decision and responsibility in each clinical situation to decide which products, modes, medications, applications, and settings to use.
- The EVIS X1™ endoscopy system is not designed for cardiac applications. Other combinations of equipment may cause ventricular fibrillation or seriously affect the cardiac function of the patient. Improper use of endoscopes may result in patient injury, infection, bleeding, and/or perforation. Complete indications, contraindications, warnings, and cautions are available in the Instructions for Use (IFU)
1) data on file Data on file with Olympus (DC00489968)
Scope : GIF-EZ1500
Case : POEM
Organ : Esophagus
Patient Information : N/A
Medical History :Achalasia
1. RDI™ technology for mucosal incision
RDI™ technology allow identification of submucosal vessel1 prior to mucosal incision for POEM to minimize bleeding
2. RDI™ technology for spindle venules
RDI™ technology enhanced recognition of spindle venules1 for localization of cardia of stomach
3. RDI™ technology for hemostasis
RDI™ technology enhanced visibility of bleeding vessel1 during gastric ESD using Dual Knife
4. RDI™ technology for bleeding vessel
RDI™ technology supported easy detection of bleeding1, which supported direct hemostasis
5. RDI™ technology for bleeding vessel
Direct hemostasis of bleeding vessel under RDI™ technology with coagrasper
Case video
POEM
Overall Comment
The EVIS X1™ imaging system supports diagnostic and therapeutic ability for endoscopic treatment of early gastrointestinal neoplasia. In therapeutic procedures, the introduction of RDI™ technology with amber light allowed visualization of blood vessels and bleeding point during therapeutic endoscopy1. I recommend the use of RDI™ during the following procedural steps during therapeutic endoscopy:
Peroral Endoscopic Myotomy (POEM)
- Mucosal incision : To allow recognition of submucosal vessel and avoid bleeding from incising on large submucosal vessel
- Recognition of spindle venules at the gastric cardia : this will define the location of end of submucosal tunnel and myotomy
* Specifications, design and accessories are subject to change without any notice or obligation on the part of the manufacturer
1) data on file Data on file with Olympus (DC00489968)
