• 2014
  • 2014

December 2014 | Full-thickness resection of adenoma in colonic diverticulum using Ovesco FTRD System

PV Valli, M Kaufmann and P Bauerfeind, Dept of Gastroenterology and Hepatology, University Hospital Zurich and B Vrugt, Institute of Pathology, University Hospital Zurich in Switzerland published the first case where colonic adenoma located from a diverticulum, a rare finding, was treated using the FTRD full-thickness resection device. The patient was a 66 year old woman with extensive diverticulosis in the entire colon. Colonoscopy revealed a 10 mm lesion (pathological size: 13 mm) inside a diverticulum in the ascending colon. Using a standard colonoscope with Indian ink injection and a hemoclip, the diverticulum was marked before a therapeutic colonoscope, fitted with the FTRD System, was introduced and advanced to the adenoma, located 10 cm proximal to the hepatic flexure. Adenoma and inverted diverticulum were mobilized into the cap of the FTRD with grasping forceps and additional suction before the FTRD clip was placed. Then resection was performed above the clip with the electrical snare integrated in the FTRD device. Histopathology showed successful full-thickness resection of a tubular adenoma with low-grade dysplasia and the resected diverticulum. The patient received single-shot peri-interventional antibiotic prophylaxis and was kept overnight for observation. Free of pain, the patient was discharged the next day, and no signs of complication arose over a 3 month follow-up period. The authors consider the new FTRD System as a secure treatment option for the resection of high-risk polyps without the risk of leakage of bowel content into the peritoneal cavity and see potential for use in an outpatient setting. To watch a video of the procedure, please visit the website of Gastroenterology journal at 
http://dx.doi.org/10.1053/j.gastro.2014.07.053

Endoscopic Resection of a Diverticulum-Arisen Colonic Adenoma Using a Full-Thickness Resection Device
Valli PV, Kaufmann M, Vrugt B, Bauerfeind P
Gastroenterology 2014, 147.5: 969-71

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