Name of the Procedure:

Small intestinal endoscopy, enteroscopy beyond second portion of duodenum (not including ileum) with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery.

Summary

A small intestinal endoscopy, or enteroscopy, involves examining the part of the small intestine beyond the second portion of the duodenum. During this procedure, doctors can remove tumors, polyps, or other lesions using specialized tools like hot biopsy forceps or bipolar cautery.

Purpose

This procedure is conducted to diagnose and treat abnormalities such as tumors, polyps, or other lesions within the small intestine. It aims to remove potentially harmful growths and prevent complications like bleeding or obstruction.

Indications

Patients experiencing unexplained gastrointestinal bleeding, abdominal pain, or signs of an intestinal obstruction may benefit from this procedure. It is also indicated for patients with suspected or known tumors or polyps within the specified part of the small intestine.

Preparation

• Patients are usually required to fast for 6-8 hours before the procedure.
• They may need to adjust their medication regimen as advised by their doctor.
• Pre-procedure diagnostics like blood tests, imaging studies, or other endoscopic procedures may be necessary.

Procedure Description

1. The patient is sedated or placed under general anesthesia.
2. An endoscope, a flexible tube with a camera and light, is inserted through the mouth and advanced into the small intestine beyond the second portion of the duodenum.
3. Tumors, polyps, or lesions are identified.
4. Hot biopsy forceps or bipolar cautery is used to remove these abnormal growths.
5. The area is then inspected for bleeding or other complications.
6. The endoscope is carefully withdrawn.

Duration

The procedure typically takes 1-3 hours, depending on the complexity and the number of lesions removed.

Setting

This procedure is typically performed in a hospital, outpatient clinic, or specialized surgical center.

Personnel

The healthcare team usually includes a gastroenterologist or surgeon skilled in endoscopy, nursing staff, and an anesthesiologist.

Risks and Complications

• Common risks: Bleeding, infection, and discomfort in the throat or abdomen.
• Rare risks: Perforation of the intestine, adverse reactions to anesthesia, or incomplete removal of lesions.
• Management: Most complications are managed with medication, observation, or additional surgical intervention if necessary.

Benefits

• Effective removal of potentially harmful lesions.
• Relief from symptoms like bleeding or pain.
• Potential early diagnosis of malignancies, improving treatment outcomes.
• Benefits are usually observed shortly after the procedure.

Recovery

• Patients are monitored for several hours post-procedure.
• They may experience mild discomfort or bloating.
• Instructions typically include rest, gradual reintroduction of food, and avoidance of strenuous activities.
• Follow-up appointments are necessary to monitor recovery and ensure all lesions were successfully removed.

Alternatives

• Non-invasive imaging like CT or MRI scans.
• Capsule endoscopy, though unable to remove lesions.
• Traditional surgery which is more invasive.
• Each alternative has its own pros and cons, such as recovery time, invasiveness, and accuracy in removing the lesions.

Patient Experience

• During the procedure, patients under sedation or anesthesia usually feel no discomfort.
• Post-procedure, mild throat soreness, bloating, or abdominal discomfort may occur.
• Pain management includes over-the-counter pain relief and following post-procedure care instructions for comfort.