Pitfalls of single-site tattooing of suspicious or significant polyps at colonoscopy in patients undergoing colectomy
DOI:
https://doi.org/10.51496/jogm.v3.103Keywords:
Colonic polyps, Colonoscopy, TattooAbstract
This is a case report of a single-site tattooing opposite the index lesion at colonoscopy. At laparoscopic surgery, the tattoo was not visible intraabdominally and on-table flexible sigmoidoscopy revealed that the tattoo was proximal to the scar tissue. Had tattoo been visible, this could have led to adverse effects with the resection point being proximal to or through the lesion. As endoscopic mucosal resection is done in patients lying flat, while surgical procedures are performed in a 30° Trendelenberg, this could have led to relative differences in the position of the tattoo and index lesion. It should become standard practice that all lesions that need tattooing should be done circumferentially distal to the index lesion. When only single-site tattooing is done, if the patient needs surgery, then a preoperative distal tattooing should be done.
References
Rees CJ, Thomas Gibson S, Rutter MD, Baragwanath P, Pullan R, Feeney M, et al. UK key performance indicators and quality assurance standards for colonoscopy. Gut 2016; 65(12): 1923–29. doi: 10.1136/gutjnl-2016-312044 DOI: https://doi.org/10.1136/gutjnl-2016-312044
Rex DK. The appropriate use and techniques of tattooing in the colon. Gastroenterol Hepatol 2018; 14(5): 314–7.
Nahid M, Shrestha AK, Imtiaz MR, Basnyat PS. Endoscopic tattooing for colorectal lesions: impact on quality of care and patient outcomes. Ann R Coll Surg Engl 2020; 102(8): 594–7. doi: 10.1308/rcsann.2020.0104 DOI: https://doi.org/10.1308/rcsann.2020.0104
Hyman N, Waye JD. Endoscopic four quadrant tattoo for the identification of colonic lesions at surgery. Gastrointest Endosc 1991; 37(1): 56–8. doi: 10.1016/S0016-5107(91)70622-6 DOI: https://doi.org/10.1016/S0016-5107(91)70622-6
Lin C-L, Chen C-P, Chiang F-F, Chen C-C, Chen M-C, Chen C-T, et al. Tattooing or metallic clip placement? A review of the outcome surrounding preoperative localization methods in minimally invasive anterior resection performed at a single center. Surg Laparosc Endosc Percutaneous Tech 2022; 32(1): 101–6. doi: 10.1097/SLE.0000000000001010 DOI: https://doi.org/10.1097/SLE.0000000000001010
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Copyright (c) 2023 Lawrence Ugwumba, Emily Oates, Sophie Noblett
This work is licensed under a Creative Commons Attribution 4.0 International License.
Journal of Global Medicine | Editor-in-Chief: Olufunso Adedeji. MBBS, MD, FRCSEd. 
