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Endoscope

Manufactured by Storz
Sourced in Germany

The Endoscope is a medical device used for visual examination of the interior of a body cavity or organ. It consists of a long, flexible tube with a camera and light source at the tip, which allows for the observation and diagnosis of various medical conditions.

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10 protocols using endoscope

1

Endoscopic Epitympanectomy and Mastoidectomy

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Adequate protective equipment was worn by the experimental team at all times. The
endoscopic procedures were performed with endoscopes (14 cm long, 3-mm diameter)
attached to a high-definition camera system and screen (Karl Storz). After
elevation of the tympanomeatal flap, the middle ear was injected with a
fluorescein solution (0.2 mg/10 mL of saline solution). Thereafter, the
epitympanum was resected with a 3-mm coarse diamond drill (Bien Air Surgery).
After suctioning of debris and fluorescein solution, the middle ear was again
injected with fluorescein. Drilling continued until the whole body of the incus
was visible.
Similarly, a microscopic epitympanectomy was performed with a surgical microscope
(Leica) via a standard retroauricular approach. The skin was retracted with hook
retractors fixed to the drapes. The simulation was completed by performing a
cortical mastoidectomy under microscopic view with standard cutting burs.
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2

Endoscopic Anatomy of Retro-and Hypotympanum

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We conducted from March 2015 to March 2016 cadaveric dissection on 83 human specimens, without any obvious temporal bone pathology. We used two 3 mm diameter, 15 cm length, endoscopes (Karl Storz, Tuttlingen, Germany) with angles of 0° and 45°, a three-CCD camera system and a high-resolution monitor (Karl Storz, Tuttlingen, Germany). The dissection was performed holding the camera in one hand (usually the left) and the instrument in the other. The exploration of the sinus required prior cleaning and removal of present mucosal folds using angled instruments.
Moreover, we reviewed 42 endoscopic ear surgery interventions carried out from January 2015 to March 2016 stored in our database. We included exclusive cases presenting unchanged anatomy of the retro-and hypotympanum. The indications to surgery were tympanic membrane perforations, retraction pockets of the attic, minor attic cholesteatoma or otosclerosis. Ten cases of extended cholesteatoma with arrosion of the bony structures of the retro-and hypotympanum were excluded from this study.
The anatomy was documented photographically and underwent further review by the authors. The final classification was tabularized and summarized. Descriptive statistics were performed using GraphPad Prism ® .
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3

Endoscopic Endonasal Cavernous Sinus Study

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All anatomical dissections were performed in the Laboratory of Microsurgical and Endoscopic Anatomy at the Medical University of Vienna. The study protocols were approved by the local institutional research committee. The cavernous sinus and surrounding structures were studied via an endoscopic endonasal approach. Specimens were injected with red silicone through the arterial system. The venous system was not injected, to facilitate recognition of cavernous sinus nerves and arteries. A 4-mm-diameter endo-scope, 18 cm in length, was used with 0° and 30° rod-lenses (Karl Storz, Tuttlingen, Germany). The endoscope was connected to a light source through a fiberoptic cable and to a camera fitted with three-chip, high-definition sensors. The video camera was connected to a monitor for optimal display of the high-definition images.
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4

Ewe Estrous Synchronization and Superovulation

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Ewe estrous cycles were synchronized by a 14-day treatment of progesterone with a controlled internal drug release (CIDR) device containing 300 mg progesterone (EAZI-BREED® CIDR® Sheep and Goats Device Pfizer Animal Health, New Zealand). The donor ewes were given consecutive injections of 45, 45, 40, 35, 35, 30, and 30 IU of FSH (Ningbo Hormone Products CO., Ltd, Ningbo, Zhengjiang, China) every 12 h, and the CIDR was removed with the last injection. Superovulation in the donors was induced by injecting 320 IU of PMSG (Ningbo Hormone Products CO., Ltd, Ningbo, Zhengjiang, China) 12 h after sponge removal. For the recipients, their CIDRs were removed 10 h in advance of the donor’s CIDR withdrawal, and the recipients were injected with a single dose of 280–320 IU PMSG. A total of 24 h after CIDR withdrawal, all ewes were exposed at 6-h intervals to a ram wearing a cloth to detect estrous onset. Artificial insemination was performed using semen freshly collected by an artificial vagina from five rams, and diluted 1:1–4 with sheep semen diluent (glucose 31 g/L, sodium citrate 14 g/L, and neomycin sulfate 1 g/L). The endoscope (Karl Storz Endoskope GmbH, Tuttlingen, Germany) intrauterine horn method was used to inseminate donor ewes with 0.2–0.5 mL of fresh semen from five different rams (motility > 0.6) at the 54th h after CIDR removal.
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5

Uniportal VATS Pulmonary Resection Technique

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The VATS resection was performed using the uniportal technique. The patients were intubated with a double lumen endotracheal tube and placed in the lateral decubitus position. A utility incision measuring approximately 3–5 cm was performed from the 5. intercostal space in the anterior position. No rib retractor was used. A 10 mm 30-degree thoracoscope (Karl Storz endoscope; Karl Storz, Tuttlingen, Germany) was used to provide a panoramic appearance and it was placed in the anterior part of the incision. Dissecting and holding clamps used in open surgery were placed through the dorsal part of the utility incision. The surgeon was at the anterior side of the patient. First, the pleural space was evaluated for suitability of thoracoscopic anatomical resection.
The dense adhesions between the lung and thorax wall were released through the aid of a small peanut-gauze, spatula-shaped electrocautery and electro-thermal bipolar tissue sealing system (Ligasure, Valleylab Inc., USA) (Photo 2). Pulmonary vessels and bronchi were dissected by an endoscopic linear cutter (Endo GIA, Covidien, USA) (Photos 3 A–C). The specimen was taken out of the incision with the aid of a protective endobag for preventing contamination. After meticulous air leak and hemorrhage control, the thorax was closed with a single chest drain placed through the posterior part of the incision (Photo 3 D).
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6

Surgical Repair of Cerebrospinal Fluid Leaks

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1. The fistulas of all patients with CSF leak were located by computed tomography cisternography (CTC) or heavy T2 magnetic resonance imaging (MRI) before surgery (9 ).
2. Before anesthesia, the patient underwent lumbar drainage implantation, and then 20 ml of normal saline was slowly injected through the lumbar drainage to observe the patient's response. If the patient had no obvious discomfort, normal saline was injected into the lumbar cistern during the operation; Otherwise, normal saline injection will not be performed.
3. The surgical approach was designed based on the preoperative imaging data. When the operation was near to the suspected fistula, the fistula was searched with endoscope,0 degree or 30 degree, 4 mm in diameter, and 18 cm in length (Karl Storz GmbH & Co KG, Tuttlingen, Germany), and then normal saline was injected through lumbar drainage (20 ml each time) to confirm the leak location. Using different repair methods, the leakage was repaired mainly by “bath-plug method” and nasal septal mucosal flap (10 (link), 11 (link)). After successful repair, saline was injected again to confirm whether the repair was successfully.
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7

Transplantation of Mouse Organoids for Rectal Cancer Modeling

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Mouse organoids were released from Matrigel using cell recovery solution, dissociated with TrypLE Express, and filtered through 100-μm nylon mesh (Falcon, 352360). Dissociated mouse organoids were resuspended in ice-cold PBS with 5% Matrigel (Corning, 354253) to a concentration of 6×106 cells/ml. Under the anesthesia with 2% isoflurane, small caliber brush (Karl Storz, 27650C) was inserted through the anus of an anesthetized female C57BL/6 mouse (The Jackson Laboratory, Bar Harbor, ME, USA) and the rectal mucosa were mechanically disrupted by gently pulling the brush out and in 2–5 times. After mechanical injury, 50 μl of mouse organoid suspension was injected slowly via anus into the mice using a p200 pipette. The anuses were then sealed by 5 μl of Vetbond tissue adhesive (3M) for 6 h and then the Vetbond was removed. The progression of endoluminal tumor was checked at 2 and 4 weeks after transplantation using small animal endoscopy (Karl Storz Endoscope, El Segundo, CA, USA). Rectum tissues were harvested at 4 weeks and fixed in 4% paraformaldehyde overnight and processed using standard histological methods. Existence of tumors was confirmed in H&E stained tissue sections. Tumor size was analyzed using Image J software and expressed as a percentage of Tumor area within a total lumen area. Rounded endoscopic area in captured images was considered as a total lumen area.
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8

Thoracoscopic Biopsy Technique for Mediastinal Masses

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The right or left lateral decubitus position was given to the patients according to the planned surgical procedure. For the mediastinal mass biopsy, a 30° supine position with a back support pad was given. In each patient, a single 2-cm incision was opened as standard, and exploration was performed with a 5-mm 30° thoracoscope camera (Karl Storz endoscope; Karl Storz, Tuttlingen, Germany). When necessary, a second incision was opened and the operation was completed biportally. Endo grasper, endo cautery, endo dissector, and surgical energy devices were used as surgical instruments. At the end of the operation, Hemovac drainage or thorax drains were placed in the thorax according to the surgeon’s preference.
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9

Endoscopic Removal of Salivary Gland Stones

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Clinical data, including sex, age, intraductal stone treatment history, involved sides, number of stones in the same gland, palpation, CBCT images (New Tom Inc., Italy), and results of endoscopic removal were collected for the patients who met the criteria. The average location, transverse diameter (TD) and longitudinal diameter (LD) of all the stones on CBCT images were recorded after evaluation by 3 blinded experienced surgeons. As demonstrated in Figure 2, the location of the stone was defined as the distance between its anterior edge and the midpoint of the glossal bony cortex of the mandible in axial CBCT views. The TD of the stone was defined as the maximum width on its axial, coronal and sagittal sections. The LD of the stone was defined as its maximum length on the axial CBCT views. We attempted to remove all of the stones included in our study with forceps or baskets after locating them with an endoscope (Karl Storz Inc., Germany), as shown in Figure 3. All endoscopic removals were performed by the same three experienced surgeons (Q.T., G.L., and H.L.).
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10

Anatomical Study of the Sublingual Artery

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This study was approved by the Institutional Review Board of Peking University First Hospital.
The anatomical dissections were conducted at the anatomy center in Peking University First Hospital. The specimens were collected from voluntary body donations to the Peking University First Hospital. In our study, we used 14 sides of SLA from heads of seven adult male fresh‐frozen and silicone‐injected cadavers with no history of trauma, surgery, and congenital malformation.
Transoral dissections were assisted by an endoscope (Karl Storz, Tuttlingen, Germany), suspension laryngoscope including the duck‐billed and Feyh‐Kastenbauer suspension laryngoscope, and microdissection instruments.
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