Gastrointestinal procedures - now surgery-free

Sheba gastrointestinal experts pull four false teeth out of patient's small intestine.

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February 21, 2007 22:44
2 minute read.
Gastrointestinal procedures - now surgery-free

dentures 298 . (photo credit: Courtesy)

Doctors at Tel Hashomer's Sheba Hospital recently pulled four false teeth from the small intestine of a patient before heart surgery, after he accidentally swallowed them, using a new device that made a major abdominal operation unnecessary. The state-of-the-art endoscope they used wriggled its way through the seven-meter long organ using a double-balloon mechanism. Sheba is the first hospital in Israel to have the $250,000 system, which was developed by Fuji of Japan and donated to the gastroenterology department by Tel Aviv philanthropist Josef Mitzri. The system can be used to perform biopsies (removal of tissue to determine if it is malignant), pinch off precancerous polyps and staunch bleeding in the small intestine, Sheba gastroenterology department head Prof. Shimon Bar-Meir told The Jerusalem Post. "For decades, we performed barium enemas to get an image of the small intestine or the stomach," he said, "but we couldn't take a biopsy from it, except by doing a major abdominal operation. Today, we can go into the large intestine [colon] or stomach with a regular endoscope and take a biopsy, remove polyps or stop bleeding. "But we still couldn't get into the small intestine, which is much longer and narrower than the large intestine. The Given Imaging video capsule that is swallowed can view the small intestine, but one can't use it to perform these procedures." The new double-balloon endoscopy system, which was introduced in the US and Europe over the past three years, enables the gastroentertologist to push his way through the small intestine without harming it or having to open the abdomen for surgery. "Why has the small intestine been so inaccessible?" Bar-Meir asked. "If you try to push an ordinary endoscope through, the small intestine stretches and loops, and then it can't pass through. This can result in perforation in the small intestine." The new system uses an "overtube" approximately 9.5 millimeters in diameter that has a balloon at the end. It is inflated after a regular endoscope has gone as far as it can, allowing the doctor to push forward in stages. The balloon is deflated while the endoscope moves farther, and then is inflated again. This process, which takes 1.5 hours to complete, allows reaching the end of the small intestine and performing procedures that make surgery unnecessary. Bar-Meir and his team treated eight patients last week and removed five polyps. One patient had previous intestinal surgery but developed new polyps. If not for the new procedure, he would have needed more surgery. In the case of the man who swallowed his dentures, the new endoscope was introduced via the rectum instead of through the throat, Bar-Meir said.


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