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• W2912876872 abstract "Pre-Bariatric endoscopic evaluations are now done routinely to exclude any significant pathology prior to surgery. Post-operative repeat assessments are also undertaken to evaluate patients for revision surgery/pouch reduction. Precise standardized measurements/volumetric assessments are challenging during endoscopy and are often varied and very subjective. We describe a very simple and novel methodology to objectively make such measurements to enable the surgeons to accurately assess the pouch/sleeve for expansion/dilatation after surgery, to optimally manage such patients. Standard upper endoscopy was performed on Bariatric patients. To enable measurements, a 2 mm pediatric biopsy forceps with colored markings 1” apart was used (Image 1). After insufflation, the measurements were made diagonally (Image 1 and 2) at level of incisura and mid portion (which was determined as half the distance from pylorus to E.G. junction procured from the external markings on scope at the level of bite block). To enable diagonal and AP measurements, the biopsy forceps was anchored after a standard forceps bite and then, the scope was partially withdrawn and swayed gently from left to right across the opposing wall while feeding the biopsy forceps into the scope to prevent the anchored end from shearing off. A 2 mm pediatric forceps in an adult scope provided adequate channel laxity to use the forceps as an instant pre-marked measuring tape, preventing the anchored end from shearing off and enabling easy movement of the scope from wall to wall with the anchored end firmly in place. The 2 mm forceps was also used for routine standard biopsies. The measurements were reported in a standard fashion using standard air insufflation to avoid gastric over-distension. This technique enabled a very objective reporting to the surgeon that is relatively more precise than visual subjective estimates of diameters and pouch sizes. There was no added cost to the procedure except for a permanent marker pen and approximately 2 minutes added time. Of the two available pediatric biopsy forceps, we noted that the spiked and coated (Boston Scientific) product provided better anchoring as well as easier marking with the pen (Image 2). Our method is simple and provides an objective measurement reporting that can be easily performed until future endoscopic or virtual imagery measurement techniques are further refined for prebariatric evaluation purposes.Figure: Images depicting the laxity of 2 mm forceps in adult scope to enable tape-like measurements.Figure: Model showing the level of measurements taken at mid body and incisura.Figure: The available makes of 2 mm forceps and the stomach model depicting the level of measurements." @default.
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• W2912876872 date "2017-10-01" @default.
• W2912876872 modified "2023-09-26" @default.
• W2912876872 title "A Novel Method of Objective Endoscopic Measurement in Adult Bariatric Patients Undergoing Preoperative Upper Endoscopy Using a 2 mm Pediatric Standard Biopsy Forceps" @default.
• W2912876872 doi "https://doi.org/10.14309/00000434-201710001-01787" @default.
• W2912876872 hasPublicationYear "2017" @default.
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