Therapeutic colonoscopy (2)

HEGAZY SURGERY

1. Therapeutic Colonoscopy

2. Lower Acute GIT bleeding PR must precede colonoscopy Preparation Small intestine (10%, blind) Colon ( Angiodysplasia , Diverticulosis ) Angiography CT angiography Others No barium

3. Intra-Operative Endoscopy

4. Obstruction Limitations and complications Stenting tumours up to sigmoid Untwisting volvulus

5. Polyps Snaring Preservation of rectum in total colectomy

6. Infammatory bowel disease Follow-up (complications) Deompression in acute dilatation

7. Tumours Distance from anal verge Associated polyps (Extent of resection / polypectopy ) Synchronous tumours Anastomotic recurrence / stricturing Tumour / Anastomotic bleeding Before reversal of H artmann’s procedure Differentiation from other diseases

8. F istula Recto vaginal fistula: Mass, from which? Biopsies Not very useful for colovesical

9. Foreign body extraction Ablation of angiodysplasia Pre-operative marking NOTES

10. Do not do colonoscopy Colonic perforation / leakage Secondary peritonitis Most cases of obstruction

11. Do colonoscopy without colonic symptoms Familial polyposis Inguinal hernia for first time in the elderly Iron deficiency anemia with no apparent cause Hepatic focal lesion indefinitely hepatoma