Considerable variability exists amongst Endoscopists in how and when they tattoo polyps. Although often called for in scientific literature, currently no standardized protocols for endoscopic tattooing exist. Therefore, the decision to tattoo or not is left to the Endoscopist’s expertise and clinical judgement.
The paper addresses the importance of preoperative tattooing for surgical localization as well as the timing of endoscopic tattoos. The authors recommend “routine tattooing of any suspicious lesion at time of diagnostic procedure”. In addition they explain that amongst tattooing substances, “Spot® Endoscopic Marker has been shown to be safe and effective without patient complications such as pain, fever or abscess formation.” Best practices for proper tattoo technique and documentation are also addressed.
The paper concludes that “a more evidence-based standardized protocol needs to be established.”
Compelling evidence exists that endoscopic tattoos are a safe and effective method to localize lesions throughout the GI tract, and aid interval surveillance of lesions. Many clinical studies and societies recommend tattooing with Spot® Endoscopic Marker. However, there is a lack of consistency amongst Endoscopists in terms of when to tattoo, endoscopic tattoo technique, and proper documentation.
Based upon available research and 2017 clinical practice guidelines on polypectomy and EMR from the European Society for Gastrointestinal Endoscopy (ESGE), GI Supply has developed an evidence-based protocol to help Endoscopists standardize tattooing. This protocol provides a simple decision tree based on clinical scenarios and can be implemented case by case.
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