India ink tattooing is a crucial technique in endoscopy, allowing surgeons to locate and resect lesions precisely, enabling minimally invasive approaches.
Proper Injection Technique
Avoid transmucosal or full-thickness needle insertion to prevent intraperitoneal injection and potential complications. Create a submucosal cushion by injecting saline first, followed by the ink, ensuring the ink remains contained within the submucosal space. This minimizes the risk of perforations and inflammatory reactions.
Tangential Needle Approach
Adopt a tangential or parallel needle insertion technique relative to the mucosal surface. This approach facilitates creating a well-defined submucosal bleb for the ink, ensuring precise marking and reducing the risk of inadvertent deep injections.
Judicious Ink Volume
Exercise caution with the volume of ink injected. Limit the injection to no more than 1-2 ml at a time, and guide the injection based on the endoscopic visualization of the ink spread. Excessive volumes can lead to unnecessary ink dispersion and potential complications.
Strategic Marking Location
Position the ink tattoo strategically in relation to the lesion. For lesions intended for endoscopic resection, mark proximal or distal to the lesion, never directly beneath, to avoid fibrosis and technical difficulties during resection. For surgical resections, mark proximal, distal, or circumferentially around the lesion to aid localization.
Mastering these essential tips will ensure accurate, safe, and effective India ink tattooing, ultimately facilitating optimal patient care through precise lesion localization and appropriate therapeutic interventions.
