By Prof. Dr. Ralf Kiesslich, Prof. Dr. Peter R. Galle, Prof. Dr. Markus Neurath (auth.)
Endomicroscopy is a newly built diagnostic software which permits in vivo microscopy with subcellular answer in the course of ongoing endoscopy within the higher and decrease gastrointestinal tract. hence, endomicroscopy is a progressive expertise since it presents the endoscopists for the 1st time with information regarding residing cells in people. Endoscopy and pathology aren't any longer separate matters and hence endomicroscopy ends up in an in depth interplay among endoscopist and pathologist. This Atlas of Endomicroscopy is the 1st e-book facing the hot insights of endomicroscopy and gives you an outline in regards to the improvement, the necessities, the strategy, present symptoms and additional probabilities of endomicroscopy.
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Extra resources for Atlas of Endomicroscopy
However, due to the limitation of angulation, some parts of the fundus and cardia are difficult or sometimes impossible to investigate . Intubation of the terminal ileum is achieved at rates similar to those with conventional colonoscopy . For endomicroscopic imaging, the confocal imaging window is placed directly onto the area of interest. The highest imaging quality is obtained by achieving full vertical contact of the confocal imaging window with the mucosa through angulation of the tip of the endoscope.
This is followed by another layer of connective tissue, the submucosal layer, which again contains immunocompetent cells (but to a lesser degree than the lamina propria), mid-sized blood vessels, and lymphatic vessels. The adjacent layer is built by the thick muscularis propria that consists of two layers – the outer longitudinal and inner circular bundles of smooth muscle. Bundles of smooth muscle cells are connected to each other by nexuses to ensure regular contractions during food and fluid passage.
While learning confocal endomicroscopy (cf. Chap. 5), close collaboration with an expert gastrointestinal histopathologist should be sought for feedback on image interpretation. The possibility of simultaneous image interpretation and collabo- ration with histopathology may even be achieved using modern telecommunication systems. Time requirements for confocal imaging have been studied in a prospective trial for colonoscopy. By adding both confocal endomicroscopy and chromoendoscopy to videoendoscopy, total examination time increased from an average of 31 min to 42 min in surveillance of patients with longstanding ulcerative colitis .