No cut mark, No pain - EUS guided Pancreatic collection treatment скачать в хорошем качестве

No cut mark, No pain - EUS guided Pancreatic collection treatment

Learning video for EUS guided pancreatic fluid drainage step by step. EUS (Endoscopic ultrasound) has revolutionized the treatment of pancreatitis. EUS guided drainage of necrotic collection and pseudocyst is now standard of care in most situation minimizing the need for surgery and reducing the morbidity and cost. Instruments needed for LAMS placement 1. EUS system 2. 19 gauge EUS FNA needle (optional) - not if HOT LAMS is used 3. Cystotome (optional) 4. HOT Axios stent system 5. Cautery machine 6. plastic stent (10/7 fr double pigtail) 7. Hydrophobic wire Steps by steps for HOT LAMS placement 1. Assess the collection - wall of collection, content of collection and size 2. Decide the site of puncture - away from GE junction, free from blood vessel field and had enough runway for sheath to enter 3. Free hand puncture of sheath with stent using pure cut current 4. Distal flangs open into cavity and then pulled back to oppose cavity wall to stomach wall 5. Proximal flangs open into scope channel to and release slowly under endoscopic view into stomach to prevent any migration 6. liquid content aspirated 7. Double pigtail plastic stent placed using fluoroscopy