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Proctology

E.P.Si.T. – Endoscopic Pilonidal Sinus Treatment

The pilonidal sinus is an acute or chronic inflammatory process in the subcutaneous adipose tissue, often occurring in the sacrococcygeal region1. E.P.Si.T. – Endoscopic Pilonidal Sinus Treatment – proceeds in two phases. In the first – diagnostic – phase, the sinus cavity and the sinus tracts are examined. The aim of the second – therapeutic – phase is to ablate the abscess cavity and to eliminate the fistula2. Both phases are performed under direct endoscopic control.

Special Features:

  • E.P.Si.T. can be performed in an outpatient setting
  • Ablation of the abscess cavity and elimination of the fistula under direct vision
  • High patient satisfaction3
  • Straightforward, safe, effective and reproducible method of treatment3
  • Instruments can also be used to treat anal fistulas (VAAFT technique)


Sources:
1 AWMF Summary of the S3 Guidelines 081/009: Sinus pilonidalis

2 Endoscopic Pilonidal Sinus Treatment: A Prospective Multicentre Trial. P. Meinero et al., 2016

3 Endoscopic Pilonidal Sinus Treatment, Giarratano G et al., 2017

Brazilian and argentinean multicentric study in the surgical minimally invasive treatment of pilonidal cyst

Human Medicine

Proctology

Silveira Mendes C R, Santana de Miranda Ferreira L, Salim L

Brazilian archives of digestive surgery 2019 Oct

Short-term outcomes of endoscopic pilonidal sinus treatment

Human Medicine

Proctology

Kalaiselvan R, Liyanage A, Rajaganeshan R

Annals of the Royal College of Surgeons of England 2019 Aug

The endoscopic treatment of pilonidal sinus disease: a short-term case-series study

Human Medicine

Proctology

Khafagy A, Al Haddad E, AlSabah S

Annals of Saudi Medicine 2019 May-Jun

Preliminary report on endoscopic pilonidal sinus treatment in children: results of a multicentric series

Human Medicine

Proctology

Pini Prato A, Mazzola C, Mattioli G, Escolino M, Esposito C, D'Alessio A, Abati LC, Leonelli L, Carlini C, Rotundi F, Meinero PC

Pediatric Surgery International 2018 Jun

Outcomes of endoscopic pilonidal sinus treatment (EPSiT): a systematic review

Human Medicine

Proctology

Tien T, Athem R, Arulampalam T

Techniques in Coloproctology 2018 May

Endoscopic pilonidal sinus treatment versus total excision with primary closure for sacrococcygeal pilonidal sinus disease in the pediatric population

Human Medicine

Proctology

Sequeira JB, Coelho A, Marinho AS, Bonet B, Carvalho F, Moreira-Pinto J

Journal of Pediatric Surgery 2018 Oct

Endoscopic Pilonidal Sinus Treatment: Long-Term Results of a Prospective Series

Human Medicine

Proctology

Giarratano G, Toscana C, Shalaby M, Buonomo O, Petrella G, Sileri P

Journal of the Society of Laparoendoscopic Surgeons 2017 Jul-Sep

Endoscopic pilonidal sinus treatment: a prospective multicentre trial

Human Medicine

Proctology

Meinero P, Stazi A, Carbone A, Fasolini F, Regusci L, La Torre M

Colorectal Disease: The Official Journal of the Association of Coloproctology of Great Britain and Ireland 2016 May

VAAFT Set

Video-Assisted Anal Fistula Treatment

The VAAFT technique is suitable for the surgical treatment of complex anal fistulas and recurrences. VAAFT – Video Assisted Anal Fistula Treatment – proceeds in two phases. The purpose of the first – diagnostic – phase is to inspect the fistula pathway and to locate the internal fistula opening. The goal of the second – therapeutic – phase is the complete destruction of the fistula epithelium. Both phases are performed under direct endoscopic control. 
Special Features: 

  • Exact localization of the internal fistula opening under visual control
  • Complete elimination of the fistula from the inside
  • Minimal postoperative trauma
  • Significant time and cost-saving potential
  • Fully autoclavable

A Systematic review and meta-analysis of the efficacy and safety of video-assisted anal fistula treatment (VAAFT)

Human Medicine

Proctology

Emile SH, Elfeki H, Shalaby M, Sakr A

Surgical Endoscopy 2018 Apr

VAAFT: Video Assisted Anal Fistula Treatment; Bringing revolution in Fistula treatment

Human Medicine

Proctology

Zarin M, Khan MI, Ahmad M, Ibrahim M, Khan MA

Pakistan Journal of Medical Sciences 2015 Sep-Oct

Video-assisted anal fistula treatment

Human Medicine

Proctology

Kochhar G, Saha S, Andley M, Kumar A, Saurabh G, Pusuluri R, Bhise V, Kumar A

Journal of the Society of Laparoendoscopic Surgeons 2014 Jul-Sep

Comparative study of clinical efficacy between video-assisted anal fistula treatment and traditional fistula resection plus seton in treatment of complex anal fistula

Human Medicine

Proctology

Zheng L, Lu J, Pu Y, Xing C, Zhao K

Chinese Journal of Gastrointestinal Surgery 2018 July

Symptom amelioration in Crohn's perianal fistulas using video assisted anal fistula treatment (VAAFT)

Human Medicine

Proctology

Adegbola SO, Sahnan K, Tozer PJ, Strouhal R, Hart AL, Lung PF, Phillips RK, Faiz O, Warusavitarne J

Journal of Crohn’s and Colitis 2018 May

Video-assisted anal fistula treatment in the management of complex anal fistula: a single-center experience

Human Medicine

Proctology

Stazi A, Izzo P, D'Angelo F, Radicchi M, Mazzi M, Tomassini F, Izzo L, Valabrega S

Minerva Chirurgica 2018 Apr

Short-term efficacy and safety of three novel sphincter-sparing techniques for anal fistulae: a systematic review

Human Medicine

Proctology

Adegbola SO, Sahnan K, Pellino G, Tozer PJ, Hart A, Phillips RKS, Warusavitarne J, Faiz OD

Techniques in Coloproctology 2017 Oct

Enterocutaneous fistula: a novel video-assisted approach

Human Medicine

Proctology

Rios HP, Goulart A, Rolanda C, Leão P

Wideochirurgia I inne techniki maloinwazyjne 2017 Sept

Video-Assisted Anal Fistula Treatment (VAAFT) for Complex Anal Fistula: A Preliminary Evaluation in China

Human Medicine

Proctology

Jiang HH, Liu HL, Li Z, Xiao YH, Li AJ, Chang Y, Zhang Y, Lv L, Lin MB

Medical Science Monitor: International Medical Journal of Experimetal and Clinical Research 2017 Apr

TEO® – Transanal Endoscopic Operations

The minimally invasive transanal platform for the treatment of rectal neoplasia

Transanal Endoscopic Operations (TEO®) combines the minimal invasiveness of an intervention via a natural body orifice (NOTES) with the precision of resection under endoscopic microsurgery.

Special Features:

  • Available in lengths of 7.5, 15 and 20 cm
  • Compatible with all standard camera systems for laparoscopy
  • Mechanical holding arm enables the platform to be placed in a very stable position

Transanal Endoscopic Operation for Benign Rectal Lesions and T1 Carcinoma

Human Medicine

Proctology

Mathieu D'Hondt, MD, Emi Yoshihara, MD, Lieven Dedrye, MD, Koen Vindevoghel, MD, Frederiek Nuytens, MD, and Hans Pottel, PhD

Journal of the Society of Laparoendoscopic Surgeons 2017 Jan-Mar

Importance of Resection Margins in the Treatment of Rectal Adenomas by Transanal Endoscopic Surgery

Human Medicine

Proctology

Serra-Aracil X, Ruiz-Edo N, Casalots-Casado A, Mora-López L, Pallisera-Lloveras A, Serra-Pla S, Puig-Diví V, Navarro-Soto S

Journal of Gastrointestinal Surgery 2018 Oct 10

What is the best tool for transanal endoscopic microsurgery (TEM)? A case-matched study in 74 patients comparing a standard platform and a disposable material

Human Medicine

Proctology

Mege D, Bridoux V, Maggiori L, Tuech JJ, Panis Y

International Journal of Colorectal Disease 2017 Jul

Transanal endoscopic resection with peritoneal entry: a word of caution

Human Medicine

Proctology

Molina G, Bordeianou L, Shellito P, Sylla P

Surgical Endoscopy 2016 May

Hybrid NOTES: TEO for transanal total mesorectal excision: intracorporeal resection and anastomosis

Human Medicine

Proctology

Xavier Serra-AracilEmail author, Laura Mora-López, Alex Casalots, Carles Pericay, Raul Guerrero, Salvador Navarro-Soto

Surgical Endoscopy 2016 January

TEO® Platform with Flexible Working Attachment and High-Flow Adaptor – B-PORT

TEO® (Transanal Endoscopic Operations) combines the minimal invasiveness of an intervention via a natural orifice (NOTES) with the precision of resection under visual control. A wide-lumen rectoscope enables precise guidance of operating instruments under endoscopic control. In cooperation with Prof. Luigi Boni, Milan, Italy, it was possible to optimize the TEO® platform for TaTME (Transanal Total Mesorectal Excision).

Special Features:

  • Great freedom of movement thanks to flexible working attachment
  • Instruments up to size 15 mm can be used
  • The high-flow adaptor enables a fast and stable pneumorectum as well as effective smoke evacuation
  • Straight distal end simplifies the placement of an endoscopic purse-string suture
  • Also suitable for TaTME

D-PORT

The reusable D-PORT was designed and optimized for transanal surgery. It is also possible to perform Transanal Total Mesorectal Excision (TaTME) with this platform.

Special Features:

  • Simultaneous CO2 insufflation and smoke / gas evacuation possible
  • Great freedom of movement due to flexible sealing cap
  • Small outer diameter of 30 mm facilitates insertion in the anal canal
  • Free choice of telescopes (5 mm or 10 mm)
  • Reusable and thus cost-effective

ENDOFLATOR® 50 and S-PILOT® – The Perfect Combination

The ENDOFLATOR® 50 in conjunction with the KARL STORZ S-PILOT® creates the perfect prerequisites for optimal smoke evacuation. To make full use of the excellent flow rate provided by the insufflator, appropriate accessories are required.

Special Features:

  • Stable OR field thanks to innovative regulation
  • Gas heating adapts to various ambient conditions and reliably prevents telescope fogging
  • Creates optimal viewing conditions and a stable OR field, even in small cavity surgery

Rectoscope for Video Documentation – RECTOVISION® with Sliding Cap

The combination of laparoscopic and rectoscopic technologies permits exceptionally good visualization and documentation of the intraluminal conditions in patients undergoing coloproctological interventions. Video rectoscopy is a straightforward and convenient procedure. RECTOVISION® is intended for use in both outpatient settings and surgical departments.

Special Features: 

  • Clear, high-resolution display of even the finest details
  • Fully reusable; long service life
  • Can be used with all 10 mm telescopes – also in conjunction with NIR/ICG for intraluminal perfusion assessment
  • Stable examination field thanks to airtight sliding cap

KARL STORZ SILVER SCOPE®

TROIDL SILVER SCOPE® Flexible Rectoscope

The flexible TROIDL SILVER SCOPE® rectoscope combines the fundamental advantages of flexible endoscopy with the application possibilities of rectoscopy.

Special Features:

  • Working length of 40 cm ensures easy handling
  • Up to 210° inversion improves visualization and, consequently, diagnostic and therapeutic options thanks to forward and retrograde viewing
  • Field of application especially suited for surgical conditions and procedures in the rectal area
  • Fatigue-free work thanks to ergonomically shaped control unit
  • Possibility to combine rigid and flexible endoscopy thanks to modular IMAGE1 S™ camera platform

Documentation in Proctology

The mobile all-in-one solution TELE PACK X GI provides clear patient information for procto- and/or rectoscopic examinations. The flexible TROIDL resectoscope as well as the rigid systems PROCTOVISION® and RECTOVISION® allow the visualization and documentation of all  examination and/or therapy steps.

Special Features:

  • The portable all-in-one solution combines a monitor, video processor, LED light source, documentation unit and insufflation pump in one unit
  • Universal use in doctors’ offices, emergency rooms and intensive care units
  • Flexible and rigid endoscopes can be easily connected with suitable adaptors
  • As well as presenting clear patient information, the documentation can be an effective aid for proctological training
  • The integrated network function allows straightforward export of patient images and videos to the hospital or practice network

SAAD Retrieval Tube

For avoiding minilaparotomy in laparoscopic colon resection

Laparoscopic techniques in colorectal resection have become increasingly established in recent years as a standard procedure in colorectal surgery1,2 although a minilaparotomy is still necessary to recover the specimen. The SAAD retrieval tube – which can be introduced both transanally and transvaginally – was designed to avoid minilaparotomy and thus significantly reduce the morbidity of the abdominal wall in the form of wound infections, postoperative pain and the formation of abdominal hernias3.

Special Features:

  • Smooth and gentle insertion thanks to anatomically adapted shape
  • The flexible working insert allows instrument use without the loss of CO2


1 Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer HJ (2012) Long-term results of laparoscopic colorectal cancer resection

2 Schwenk W, Haase O, Neudecker JJ, Müller JM (2008) Short-term benefits of laparoscopic colorectal resection

3 Brockhaus AC, Politt D, Lindlohr C, Saad S (2016) Transanal extraction vs. minilaparotomy for laparoendoscopic left-sided colon resection

Proctoscopes

KARL STORZ offers a wide range of proctoscopes in various sizes for rigid proctoscopy.

Special Features:

  • Plastic obturator prevents possible tilting in the proctoscope tube
  • Completely reusable, durable
  • With the proper working attachment can also be utilized for video-assisted proctoscopy and documentation

Rectoscopes

KARL STORZ offers a wide range of rectoscopes in various sizes for rigid rectoscopy.

Special Features:

  • Completely reusable, durable
  • Fiber optic light carrier with fiber optic light cable connector for optimal illumination
  • With the proper working attachment can also be utilized for video-assisted rectoscopy and documentation

 

Hemorrhoid Treatment

KARL STORZ offers a wide range of suction ligature instruments for the treatment of hemorrhoids

Special Features:

  • Available with integrated mechanical vacuum pump or with connector pin for external vacuum pump
  • Replaceable, ergonomic handle
  • Available with lateral or straight suction openings