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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
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Related Experiment Video

Updated: Aug 16, 2025

Laparoscopic Duodenum-Preserving Pancreatic Head Resection via Inferior Infracolic Approach: A Surgical Approach for Benign Lesions
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How I do it:- Endoscopic Reverse Denker's Approach.

Nagalingeswaran Ahilasamy1, Veerasigamani Narendrakumar2, Rajendran Dinesh Kumar3

  • 1Consultant, Ahilasamy ENT Centre, 600 042 Chennai, Tamil Nadu India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|December 26, 2022
PubMed
Summary

Endoscopic Reverse Denker's approach offers a minimally invasive technique for maxillary sinus surgery. This endoscopic method preserves nasal structures, reduces complications, and improves outcomes compared to open approaches.

Keywords:
AnteriorEndoscopicMaxillary SinusReverse Denker’s

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Area of Science:

  • Otolaryngology
  • Endoscopic Sinus Surgery

Background:

  • Open approaches to the maxillary sinus carry risks like cranial nerve dysfunction and trismus.
  • Surgical techniques vary based on pathology, required exposure, and clearance extent.

Purpose of the Study:

  • To present the technique and surgical steps of the Endoscopic Reverse Denker's approach.
  • To highlight the advantages of this endoscopic method for maxillary sinus pathology.

Main Methods:

  • The technique involves inferior turbinectomy, uncinectomy, and mega middle meatal antrostomy.
  • Drilling from the anterior margin of the antrostomy to the anterior maxillary wall visualizes the nasolacrimal duct for transection.
  • This approach preserves the pyriform aperture and anterior wall, minimizing bone removal.

Main Results:

  • The Endoscopic Reverse Denker's approach provides excellent exposure of the maxillary sinus anterolateral and anterior walls.
  • This technique results in less bone removal, reduced morbidity, and faster recovery.
  • Preservation of the pyriform aperture prevents alar collapse, and olfaction is maintained with less crusting.

Conclusions:

  • Endoscopic Reverse Denker's is an effective 2- or 4-handed endoscopic technique for maxillary sinus pathology.
  • It offers superior visualization and clearance with preserved olfaction and reduced nasal changes.
  • The method avoids atrophic nasal changes and prevents alar collapse by preserving the pyriform aperture.