期刊
JOURNAL OF CLINICAL MEDICINE
卷 12, 期 21, 页码 -出版社
MDPI
DOI: 10.3390/jcm12216822
关键词
operative endoscopy; supine; prone; patient position; ESD; POEM; ERCP; colonoscopy
This paper examines the importance of patient positioning in endoscopic procedures, discussing how gravity can affect various factors during the surgery and emphasizing the need for endoscopists to consider the patient's anatomy and endoscope position.
It is well known by surgeons that patient positioning is fundamental to exposing the organs when performing an operation via laparoscopy, as gravity can help move the organs and facilitate the exposure of the surgical site. But is it also important for endoscopic procedures? This paper examines various types of endoscopic operations and addresses the issue of the patient's position. The patient's position can be changed not only by rotating the patient along the head-toe axis but also by tilting the surgical bed, as is undertaken during laparoscopic surgical procedures. In particular, it is useful to take into account the effect of gravity on lesion exposure, tumour traction during dissection, crushing by body weight, risk of sample drop, risk of damage to adjacent organs, and anatomical exposure for procedures with radiological support. The endoscopist should always keep in mind the patient's anatomy and the position of the endoscope during operative procedures, not limited to considering only intraluminal vision.
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