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Endoscopic
Colonoscopy
Colonoscopy is perhaps the most effective method of diagnosing and also preventing colorectal cancer. The way colonoscopy prevents colorectal cancer is by stopping polyps turning into cancers. 1 in 20 people will get colorectal cancer but if there is a close relative who also had the disease then the odds can be as low as 1 in 10. After clearing out the bowels a colonoscopy can be performed under minimal sedation in 75% of patients, and more than 90% of the time the whole colon can be viewed.
As many as 1 in 3 people get polyps (which are wart like growths) in the large bowel. Colonoscopy detects over 90% of polyps, which can be destroyed or snared. It is important you know your surgeons major bleeding and perforation rate for this procedure and the risk to benefit ratio is discussed beforehand. I carry out over 250 colonoscopies every year and currently have a 0% perforation rate.
Introduction
Transanal endoscopic microsurgery (TEMS) is a minimally invasive surgical technique, which is performed endoluminally (inside the lumen of the rectum). It is primarily used for the removal of rectal tumours, both benign and malignant that cannot be removed by colonoscopy. The procedure may also be used on patients who are unfit or unwilling to undergo conventional open surgery. The relatively elderly local Dorset population forms a group perhaps most appropriate for the use of TEMS.
NOTES
NOTES: Because we Can or Because we Should?
Manish Chand and Guy F Nash
The demands of surgical evolution necessitate constant improvement, but may some technological advances be ultimately detrimental to what we set out to achieve? Natural Orifice Transendoluminal Surgery− (NOTES−) is a novel surgical technique which shatters the traditional boundaries of minimally-invasive surgery. Potentially the most exciting surgical innovation since the inception of laparoscopic surgery, encouraging reports of NOTES procedures have been seen in animal models, ranging from diagnostic biopsies to cholecystectomies. But with reports of the first human trials recently published – the operation Anubis – there is a danger that such technological advances, rather than benefit patients, may present safety risks similar to those experienced early in the history of laparoscopic surgery.
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The Harbour Hospital
Bournemouth Nuffield
