using-the-endoscope-for-endobronchial-ultrasound-in-the-esophagus

Using the Endoscope for Endobronchial Ultrasound in the Esophagus

EUS-B is a procedure using the echoendobronchoscope in the esophagus and stomach. The procedure is a minimally invasive, safe, and feasible approach that ...

Copenhagen University Hospital, Rigshospitalet

Diagnostic imaging often outperforms the surgeon's ability to identify small structures during therapeutic procedures. Smart soft tissue markers that translate the sensitivity of diagnostic imaging into optimal therapeutic intervention are therefore highly warranted. This paper presents a unique adaptable liquid soft tissue marker system based on functionalized carbohydrates (Carbo-gel). The liquid state of these markers allows for high-precision placement under image guidance using thin needles. Based on step-by-step modifications, the image features and mechanical properties of markers can be optimized to bridge diagnostic imaging and specific therapeutic interventions. The performance of Carbo-gel is demonstrated for markers that (i) have radiographic, magnetic resonance, and ultrasound visibility; (ii) are palpable and visible; and (iii) are localizable by near-infrared fluorescence and radio guidance. The study demonstrates encouraging proof of concept for the liquid marker system as a well-tolerated multimodal imaging marker that can improve image-guided radiotherapy and surgical interventions, including robotic surgery.

Multimodal soft tissue markers for bridging high-resolution diagnostic imaging with therapeutic intervention.

The use of one single ultrasound echoendoscope in both the trachea (EBUS) and the oesophagus (EUS-B) gives a fast, safe and precise diagnosis and stage of the patient with suspected lung cancer. There is solid evidence for simulator-based training in EBUS concerning safety and diagnostic outcome, but this is currently not an option in EUS-B and needs development. In this review, we recommend evidence-based simulator training and certification in EBUS and when available also in EUS-B before practicing on patients.

Paul F. Clementsen

Copenhagen Academy for Medical Education and Simulation (CAMES)

Copenhagen University Hospital, Rigshospitalet

Using the Endoscope for Endobronchial Ultrasound in the Esophagus

Paul F. Clementsen

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Copenhagen University Hospital, Rigshospitalet

Using the Endoscope for Endobronchial Ultrasound in the Esophagus

Copenhagen Academy for Medical Education and Simulation (CAMES)