A radiation-free novel approach for intestinal stent placement: the “scope-in-scope” technique

作者：Jiaqing Hu, Jinhui Zheng, Changshun Yang, Xiang Gao, Xianbin Guo, Xiaoling Zheng · 发表于：Endoscopy · 年份：2024 · DOI：10.1055/a-2291-9315 · 被引用次数：2 · 研究领域：Appendicitis Diagnosis and Management、Diverticular Disease and Complications、Cardiac, Anesthesia and Surgical Outcomes

An elderly woman with persistent abdominal pain and bloating was diagnosed with obstructive sigmoid colon cancer on computed tomography (CT) ([ Fig. 1 ]). Because of a low oxygen saturation value caused by secondary aspiration pneumonia she was admitted to the intensive care unit; therefore transfer to a fluoroscopy-equipped operating room was inappropriate. Fig. 1 Abdominal computed tomography in an elderly woman, showing a sigmoid colon mass with distension of the distal bowel (arrow). After multidisciplinary discussions, colonic stent placement was decided upon, using the “scope-in-scope” technique that combines digital single-operator cholangioscopy with colonoscopy. The colonoscope was used to approach the sigmoid colon, where an infiltrative mass was causing luminal narrowing ([ Fig. 2 ]). Then the cholangioscope (9-Fr, EyeMax; Micro-Tech, Nanjing, China) was inserted directly through the colonoscope biopsy channel. Fig. 2 Colonoscopy showed an infiltrative mass in the sigmoid colon, accompanied by luminal narrowing. The forward direction of the cholangioscope can be flexibly adjusted using the operating unit ([ Video 1 ]) and narrow lumens can be navigated under direct visualization. Thus clear observation of the internal structure of the colonic tumor was possible ([ Fig. 3 ]). The cholangioscope was advanced accompanied by irrigation with saline. Passage beyond the obstructed segment was confirmed when dilated intestinal lumen was seen ([ Fig. 4 ]). Quality: mobile 3...