Gel immersion endoscopy: Innovation in securing the visual field – Clinical experience with 265 consecutive procedures
Tomonori Yano, Takahito Takezawa, Kousei Hashimoto, Ayako Ohmori, Satoshi Shinozaki, Manabu Nagayama, Hirotsugu Sakamoto, Yoshimasa Mıura, Yoshikazu Hayashi, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
Abstract
During endoscopy, especially in patients with gastrointestinal bleeding, it is often difficult to secure the visual field. Although water immersion techniques are sometimes used to mitigate this situation [1] [2] [3], maintenance of the visual field is often difficult because the infused/injected water rapidly mixes with any luminal blood and/or residue. Poor preparation before colonoscopy also makes it difficult to secure the visual field when using water immersion or water exchange techniques. The use of gas insufflation to displace luminal contents can cause significant discomfort and difficult endoscope insertion. It is also often impossible to adequately aspirate blood, clots and residue. Although positional changes may improve visualization through gravity, this strategy is also ineffective at times.