Description of Event or Problem · 0
ON (B)(6), OLYMPUS MEDICAL SYSTEMS CORP. (OMSC) RECEIVED THE LITERATURE "INSULATED-TIP KNIFE TUNNELING AND C-SHAPED INCISION FOR ESOPHAGEAL ENDOSCOPIC SUBMUCOSAL DISSECTION: AN INITIAL WESTERN EXPERIENCE¿. THE PURPOSE OF THE LITERATURE WAS TO INVESTIGATE THE FEASIBILITY AND SAFETY OF IT-KNIFE TUNNELING AND C-SHAPED INCISION ESOPHAGEAL ESD IN THE WEST. ALL ESD PROCEDURES WERE PERFORMED WITH AN OLYMPUS GIF-H190 UPPER ENDOSCOPE (OLYMPUS) FITTED WITH A DISPOSABLE STRAIGHT SOFT DISTAL ATTACHMENT (D-201-11804; OLYMPUS). IF SUBMUCOSAL FIBROSIS WAS ENCOUNTERED, ESD TECHNIQUE WOULD BE CONVERTED TO DUALKNIFE (KD-650U; OLYMPUS) DISSECTION FOR THE FIBROTIC AREAS. A DUALKNIFE WAS USED FOR MAKING CAUTERY MARKINGS AROUND THE LESION AND AN IT-KNIFE NANO (KD-610L; OLYMPUS) WAS USED FOR SUBMUCOSAL DISSECTION. BLOOD VESSEL COAGULATION WAS PERFORMED WITH A COAGRASPER HEMOSTATIC FORCEPS (FD-410LR; OLYMPUS). AN ELECTROSURGICAL GENERATOR AND AN INJECTION NEEDLE WERE USED, BUT THE DEVICES WERE NON-OLYMPUS DEVICES. IN THE LITERATURE, IT WAS REPORTED ONE CASE OF AN INTRAPROCEDURAL BLEEDING REQUIRING ONE UNIT OF PACKED RED BLOOD CELLS AND ONE CASE OF A DELAYED BLEEDING REQUIRING EMERGENCY ENDOSCOPY. THERE IS NO MORE INFORMATION ABOUT ONE CASE OF AN INTRAPROCEDURAL BLEEDING REQUIRING ONE UNIT OF PACKED RED BLOOD CELLS. THE LITERATURE WROTE, ¿THERE WAS ONE CASE WITH DELAYED BLEEDING REQUIRING EMERGENCY ENDOSCOPY. THIS PATIENT WAS A CIRRHOTIC WHO DID NOT REQUIRE A BLOOD TRANSFUSION BUT REPEAT ENDOSCOPY NOTED A BLEEDING SUBMUCOSAL VESSEL THAT WAS COAGULATED.¿ BASED ON THE AVAILABLE INFORMATION, A DIRECT RELATIONSHIP BETWEEN THE OLYMPUS PRODUCT AND THESE COMPLICATIONS COULD NOT BE DETERMINED. HOWEVER, ONE CASE OF AN INTRAPROCEDURAL BLEEDING REQUIRING ONE UNIT OF PACKED RED BLOOD CELLS AND ONE CASE OF A DELAYED BLEEDING REQUIRING EMERGENCY ENDOSCOPY MIGHT BE SERIOUS INJURY, AND THE OLYMPUS KNIFE MIGHT BE USED WHEN THE CASES OCCURRED. THIS IS THE REPORT REGARDING ONE CASE OF AN INTRAPROCEDURAL BLEEDING REQUIRING ONE UNIT OF PACKED RED BLOOD CELLS.