A clinical case using Alton Medical instruments
Head of the multidisciplinary surgical department, doctor-endoscopist of the first category, associate professor of the Department of Faculty Surgery of ZDMU.
He is a valid member of the Association of Endoscopists of Ukraine, ESGE (European Society Gastroenterology Endoscopy), WEO (world endoscopy society), IDEN (international digestive endoscopy network), Opinion Leader of Alton Ukraine.
Co-author of 10 scientific papers, participated in 10 conferences with international participation and 5 European conferences with reports on various current endoscopic topics. He has 3 theses publications in the journal Endoscopy 2021.
Problem
Your attention is a unique case, for the first time endoscopic treatment of a patient with Hirschsprung's disease was performed using the PREM (per rectum endoscopic myotomy) method.
28-year-old patient, recurrence of Hirschsprung's disease according to MSCT and radiological data (passage of contrast material) - phenomena of colon dilatation and persistent spasm of the rectum, with defecation disorder. From the anamnesis: he has been sick since childhood, at the age of 4 he underwent a resection of the rectosigmoid part of the large intestine, then there was an obstruction. operated with colostomy removal. Exacerbation last year, increased intake of laxatives. I asked for help. Endoscopic operation PREM was offered!
Toolkit
The tools used during endoscopic manipulation are as follows:
- Gastroscope GIF 190HQ,
- distal attachment FUJINON DH-28GR naroowed,
- endoscopic knife Duol knife 1.5 mm,
- Alton Medical Instruments triangle knife,
- surgical unit BOWA ARC 400.
- Clip close Alton Medical Instruments Hemoclip 11mm.
The length of the myotomy is 15 cm.
Result
In this case, on radiography with a contrast agent, the rectum is dilated, the bowel movement is satisfactory and complete.
Head of the multidisciplinary surgical department, doctor-endoscopist of the first category, associate professor of the Department of Faculty Surgery of ZDMU.
He is a valid member of the Association of Endoscopists of Ukraine, ESGE (European Society Gastroenterology Endoscopy), WEO (world endoscopy society), IDEN (international digestive endoscopy network), Opinion Leader of Alton Ukraine.
Co-author of 10 scientific papers, participated in 10 conferences with international participation and 5 European conferences with reports on various current endoscopic topics. He has 3 theses publications in the journal Endoscopy 2021.