Gastrointestinal endoscopy clinics of North America
-
Gastrointest. Endosc. Clin. N. Am. · Apr 2011
ReviewBariatric surgical anatomy and mechanisms of action.
Because bariatric surgery is becoming increasingly common, gastroenterologists need to be familiar with the surgical and endoscopic anatomy of the operations in use today. This review focuses on the 4 most commonly performed bariatric operations in the United States: Roux-en-Y gastric bypass, adjustable gastric band, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch. ⋯ Emphasis is placed on the endoscopic anatomy, with review of the commonly encountered complications. Emerging techniques and devices are reviewed.
-
Gastrointest. Endosc. Clin. N. Am. · Apr 2011
ReviewEndoscopy unit considerations in the care of obese patients.
The dramatic increase in obesity in the general population is accompanied by a concomitant increase in bariatric surgical programs. Gastrointestinal endoscopy has an important role in patient evaluation, postoperative management, and emerging endoscopic bariatric therapies. ⋯ Obese people require more health care resources than nonobese people, with increased physical challenges for staff in administering that care. This article details endoscopy unit considerations pertaining to the bariatric patient, which may apply to pretreatment endoscopic evaluation, managing postoperative bariatric surgical complications, and emerging endoluminal bariatric therapies.
-
Gastrointest. Endosc. Clin. N. Am. · Oct 2010
ReviewThe use of databases and registries to enhance colonoscopy quality.
Administrative databases, registries, and clinical databases are designed for different purposes and therefore have different advantages and disadvantages in providing data for enhancing quality. Administrative databases provide the advantages of size, availability, and generalizability, but are subject to constraints inherent in the coding systems used and from data collection methods optimized for billing. ⋯ Electronic health records contain all of the data needed for quality research and measurement, but that data is too often locked in narrative text and unavailable for analysis. National mandates for electronic health record implementation and functionality will likely change this landscape in the near future.
-
Gastrointest. Endosc. Clin. N. Am. · Oct 2010
ReviewMaximizing the value of the endoscopist-pathologist partnership in the management of colorectal polyps and carcinoma.
Good communication between clinician and pathologist is essential for optimal patient care and management of colorectal polyps and carcinoma. General principles of communication include making sure that the pathologist and endoscopist have all the information needed to make an accurate diagnosis and that the pathologist communicates the diagnosis back to the endoscopist in a clear and timely fashion. The increasing complexity of classification of colorectal polyps and carcinomas has added to the need for clear communication pathways. The first part of this article is devoted to an outline of general communication issues; the second is a discussion of current concepts in colorectal polyps and carcinomas.
-
Colonoscopy is a well recognized diagnostic and therapeutic tool. Endoscope reprocessing must be done correctly every time; a breach of protocol leading to transmission of infection has the potential to bring endoscopy to a halt. Standards exist that guide the practitioner in all health care settings to minimize the chance of transmission of infection. Safe injection practices and reprocessing of endoscopes using high-level disinfection and sterilization methods may help avert the risk of contracting possible infections during colonoscopy procedures.