ATLAS for ENDOSCOPIC and SURGICAL ANATOMY of the GASTROINTESTINAL TRACT > Gastroenterology

Foreword

It has been half a century since endoscopes have been used for treating digestive diseases. Originally developed as diagnostic tools, endoscopes are now widely used as therapeutic tools. The scope of endoscopy at the station is gradually expanding. However, it still requires a lot of research to treat a variety of digestive diseases.

The Korean Society of Gastrointestinal Endoscopy (KSGE) had formed “ESD Research” and “NOTES Research” groups to advance the field of therapeutic endoscopy. Both groups have been reorganized into a single research group for multidisciplinary therapeutic endoscopy since 2020. Here, expert endoscopists as well as those interested gather to study endoscopic treatments for digestive diseases.

The research group for multidisciplinary therapeutic endoscopy published the “Atlas for Endoscopic and Surgical Anatomy of the gastrointestinal tract”.

The atlas focused on gastrointestinal anatomy to help the endoscope, which only covers the inside of the gastrointestinal tract, in understanding the structures outside the gastrointestinal tract.

Therefore, I think this book will help not only those who want to pursue therapeutic endoscopy, but also specialists currently performing the procedure. We also believe this book will help expand the bottom door and advance medicine in therapeutic endoscopy.

Thank you to the originals and everyone who did their best to participate in the writing until publication. We also thank the publishing officials for their efforts in ensuring smooth publication processes.

The KSGE will continue to do our best to grow into a high-quality society dedicated to diagnosing and treating digestive diseases.

Thank you again.

November 2021

President of Korean Society of Gastrointestinal Endoscopy   Joo Young Cho 

Chairman of Korean Society of Gastrointestinal Endoscopy   Hyung Kil Kim 

Committee president of The Research Group for Multidisciplinary Therapeutic Endoscopy   Kwang Bum Cho

Preface

The development of modern medicine has enabled an era in which minimally invasive surgical methods are commonly applied for treating gastrointestinal tumors. The activation of national cancer screening projects and the universalization of endoscopic screenings has increased early detection of adenoma, gastric cancers, and asymptomatic colon polyp, which also resulted in a quantitative  increase in endoscopic resection.

Additionally, due to the dedication and efforts of the Korean Society of Gastrointestinal Endoscopy (KSGE) and many members through research presentations, education through the seminars of societies, and care at their respective hospitals, endoscopic submucosal dissection achieved an upward standardization of the qualitative level of the entire country.

More than 20 years after endoscopic therapies were introduced in Korea, the KSGE has conducted seminars and training sessions, live demonstrations, and hands-on courses annually to improve the standardization and quality of endoscopic procedures.

The “Atlas for Endoscopic and surgical anatomy of the gastrointestinal tract,” published by the Research Group for Multidisciplinary Therapeutic Endoscopy, is needed by endoscopists to help understand gastrointestinal and external structures. During therapeutic endoscopy, it is necessary to understand the external structure of the gastrointestinal tract to facilitate the procedure, while only the tract is observed.

The textbook wanted to help understand and compare the structures surrounding the gastrointestinal tract, including the oral cavity, esophagus, mediastinum, stomach, and small intestine, through photographs and illustrations. Therefore, it is useful for majors in endoscopy or interested gastroenterologists.

Finally, I would like to thank the authors for their work in publishing the booklet, the Research Group for Multidisciplinary Therapeutic Endoscopy for editing, the executive branch of the KSGE for their full support, and the publishers of the book.

November 2021

Committee president of The Research Group for Multidisciplinary Therapeutic Endoscopy  

Kwang Bum Cho

PART 1 Oral Cavity & Esophagus
Chapter 1 Anatomy of the Oral cavity, Pharynx, and Larynx 2
Oral cavity 2
Pharynx 4
Larynx 6
Chapter 2 Anatomy of the Esophagus 11
Anatomy of the esophagus 12
Surrounding anatomy of esophagus 19
Cross section anatomy 21
Chapter 3 Anatomy of Mediastinum 23
Normal anatomy of mediastinum 23
Mediastinal lymph node 27
Chapter 4 The Esophagus and Surrounding structures 28
Laparoscopic fundoplication 28
Esophageal myotomy 31
Esophagectomy 36
Esophageal rupture 49

PART 2 Stomach
Chapter 1 Anatomy of the Stomach 52
Anatomy of the stomach 52
Surrounding anatomy of the stomach 65
EG junction anatomy 66
Chapter 2 Anatomical Change after Stomach Surgery 67
Gastric cancer surgery 67
Anti-reflux surgery 82
Obesity surgery 84
Chapter 3 Anatomy for Gastric ESD Procedure 87
Basic steps of an ESD procedure for early gastric cancer 87
Submucosal dissection in a gravity-dependent manner by location 88
Muscular structure of the pyloric sphincter 95
Dissection of the lesion with severe fibrosis 96
Chapter 4 Anatomy that can be helpful during PEG 97
Techniques of percutaneous endoscopic gastrostomy (PEG) 97
Surrounding anatomy of the stomach 101
Complications of PEG 103
Chapter 5 Anatomy for Gastric Laparoscopic and Endoscopic Cooperation Surgery 108
Surrounding anatomy of the stomach 108
Laparoscopic procedures before endoscopic full-thickness resection (EFTR) 121
Sentinel node evaluation 123
A case of laparoscopic and endoscopic cooperative surgery (LECS) 124


PART 3 Small & Large Intestine
Chapter 1 Anatomy of the Small Intestine 128
Normal anatomy 128
Duodenal ulcer 133
Small bowel obstruction 135
Diverticular disease 137
Neoplasm 140
Others 146
Chapter 2 Understanding of Normal Anatomy of Colon 147
Normal anatomy of the colon 147
Terminal ileum 150
Cecum 151
Ascending colon 152
Hepatic flexure 152
Transverse colon 154
Splenic flexure 154
Descending colon 156
Sigmoid colon 157
Rectum 159
Chapter 3 Anatomy of the Colon, Rectum, & Anus 162
Anatomy of colon & rectum 162
Anatomy of the anus 180
Chapter 4 ESD in the Colon 188
Ileocecal valve 191
Cecum 192
Ascending colon 193
Hepatic flexure 194
Transverse colon 195
Splenic flexure 196
Descending colon 197
Sigmoid colon 198
Rectum 199
Chapter 5 Tattoo Marking of the Colon: Both Side Views from the Endoscopist and Surgeon 200
Tattooing on a splenic flexure tumor 200
Tattooing on a rectal tumor 201
Over-injection 203

PART 4 Procedural or Surgery-related Complications
Chapter 1 Perforation 206
Chapter 2 Stricture and Leakage 218
Chapter 3 Others 226


PART 5 Technique and Anatomy of Pediatric Endoscopy
Chapter 1 Precautions for Pediatric Endoscopy 232
Chapter 2 Normal anatomy of Pediatric Esophagoduodenoscopy 233
Chapter 3 Surgical Anatomy of Unique Pediatric Gastrointestinal Disease 237
Tracheo-esophageal fistula 237
Hypertrophic pyloric stenosis 239
Peutz-Jeghers syndrome (PJS) 241
Chapter 4 Therapeutic Pediatric Esophagoduodenoscopy 243
Per-oral endoscopic myotomy (POEM) for achalasia 243
Endoscopic dilatation for esophageal ring or web 250
Foreign body (FB) removal from the esophagus or stomach 252
Polypectomy 257