The Incidence and Cost of Unexpected Hospital Use After Scheduled Outpatient Endoscopy

Leffler, Daniel A.; Kheraj, Rakhi; Garud, Sagar; Neeman, Naama; Nathanson, Larry; Kelly, Ciarán P.; Sawhney, Mandeep S.; Landon, Bruce E.; Doyle, Richard J.; Rosenberg, Stanley; Aronson, Mark D.

doi:10.1001/archinternmed.2010.373

Cited by 97 publications

(62 citation statements)

References 28 publications

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“…contributed equally to this work. 2 To whom correspondence should be addressed. Email: jaiz@seas.harvard.edu.…”

Section: Significancementioning

confidence: 99%

“…Endoscope operators use the device to inspect interior regions of the human body and, in the case of flexible endoscopes, to obtain samples for diagnostic studies and to provide minimally invasive therapy via instruments passed through the working channel (1,2). All these procedures bring the camera lens in close contact with body fluids, which adsorb onto the lens and compromise the visual field, risking imprecise or undesired movements of the device that damage the surrounding tissue and harm the patient.…”

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confidence: 99%

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Transparent antifouling material for improved operative field visibility in endoscopy

Sunny

Cheng

Daniel

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

122

125

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Camera-guided instruments, such as endoscopes, have become an essential component of contemporary medicine. The 15–20 million endoscopies performed every year in the United States alone demonstrate the tremendous impact of this technology. However, doctors heavily rely on the visual feedback provided by the endoscope camera, which is routinely compromised when body fluids and fogging occlude the lens, requiring lengthy cleaning procedures that include irrigation, tissue rubbing, suction, and even temporary removal of the endoscope for external cleaning. Bronchoscopies are especially affected because they are performed on delicate tissue, in high-humidity environments with exposure to extremely adhesive biological fluids such as mucus and blood. Here, we present a repellent, liquid-infused coating on an endoscope lens capable of preventing vision loss after repeated submersions in blood and mucus. The material properties of the coating, including conformability, mechanical adhesion, transparency, oil type, and biocompatibility, were optimized in comprehensive in vitro and ex vivo studies. Extensive bronchoscopy procedures performed in vivo on porcine lungs showed significantly reduced fouling, resulting in either unnecessary or ∼10–15 times shorter and less intensive lens clearing procedures compared with an untreated endoscope. We believe that the material developed in this study opens up opportunities in the design of next-generation endoscopes that will improve visual field, display unprecedented antibacterial and antifouling properties, reduce the duration of the procedure, and enable visualization of currently unreachable parts of the body, thus offering enormous potential for disease diagnosis and treatment.

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“…contributed equally to this work. 2 To whom correspondence should be addressed. Email: jaiz@seas.harvard.edu.…”

Section: Significancementioning

confidence: 99%

mentioning

confidence: 99%

Transparent antifouling material for improved operative field visibility in endoscopy

Sunny

Cheng

Daniel

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

122

125

View full text Add to dashboard Cite

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“…Medical center billing records have been used in prior studies [11][12][13] to accurately determine the numbers and timing of interventional procedures performed during a specified period. Nasogastric tube placement is not reliably captured by this method, and cases of methemoglobinemia related to NGT placement were excluded from the calculation of the overall and procedurespecific incidences.…”

Section: Methodsmentioning

confidence: 99%

Risk of Topical Anesthetic–Induced Methemoglobinemia

Chowdhary¹,

Bukoye²,

Bhansali³

et al. 2013

JAMA Intern Med

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“…As a consequence, some of the complications may arise after the completion of this surgery as the emergence of strictures, fistulas, ring migration and regained weight, conditions which until recently were resolved through a new surgical procedures [7,8]. …”

Section: Short Communicationmentioning

confidence: 99%

Proposed Experimental Model for Qualification of Endoscopic Practices

Quadros¹,

Silva²,

Neto³

et al. 2015

Int J Gastroenterol Disord Ther

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Background: It is estimated that about 80 million Americans are affected by digestive diseases, and about 30 million endoscopic procedures are performed annually in the US. In Brazil, it was estimated that the national average of endoscopies number was 600 tests / 100,000 inhabitants per year. Despite the common nature of the procedures, there is no standard methodology for the training of endoscopists or when a trainee met important technical competence. In addition, there is no tool that determines the qualification of front trainees to familiarize themselves with the endoscope and endoscopic equipment for clinicalprocedures. Aim: to validate an experimental model through the use of the upper gastrointestinal tract of swine (pig), shaping it with use of linear staplers, manual anastomoses and mannequins in order to train and improve the technical endoscopic. Methods:advancement and improvement of endoscopic practices and procedures by new experimental model will help the emergence of a sector of this area facing the resolution of these complications of bariatric surgery. Results: Endoscopic practices, using the experimental model of the gastrointestinal tract of pigs, were significant to provide better training and capacity building to endoscopy professionals, as demonstrated in the videos. Conclusion: the endoscopies professionals were able to safely simulate the endoscopic procedure in an experimental model, thus ensuring the new technical training. Proposed Experimental Model for Qualification of Endoscopic Practices Keywords:Endoscopic technique improvement, Training, Animal model Short Communication Open Access Short CommunicationIt is estimated that about 80 million Americans are affected by digestive diseases, and about 30 million endoscopic procedures are performed annually in the US [1,2]. In Brazil, it was estimated that the national average of endoscopies number was 600 tests / 100,000 inhabitants per year [3][4][5][6]. This number compared with the data collected from public health services in England, the Netherlands and Ireland, respectively 1000, 1200 and 1400 by 100,000 / inhabitants / year [6,8].Thus, it is observed that in Brazil the average number of examinations per year is lower compared to other countries, being necessary to invest in training techniques to facilitate the inclusion of new professionals as well as improving the skills of professionals [6]. Despite the common nature of the procedures, there is no standard methodology for the training of endoscopists or when a trainee met important technical competence. In addition, there is no tool that determines the qualification of front trainees to familiarize themselves with the endoscope and endoscopic equipment for clinical procedures [3,4].As demand requirement, there is an increasing number of patients undergoing bariatric surgery that is increasingly demanding that professionals know the therapeutic and endoscopic aspects of the main gastroenterological repercussions of bariatric operations [1,2,3]. As a consequence, some...

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The Incidence and Cost of Unexpected Hospital Use After Scheduled Outpatient Endoscopy

Cited by 97 publications

References 28 publications

Transparent antifouling material for improved operative field visibility in endoscopy

Transparent antifouling material for improved operative field visibility in endoscopy

Risk of Topical Anesthetic–Induced Methemoglobinemia

Proposed Experimental Model for Qualification of Endoscopic Practices

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