During our international uplift process in the UK, we identified that some UK Endoscopic procedure concepts no longer infer under 363687006 |Endoscopic procedure (procedure)|. This is because of a modelling change to the core concept 363687006 |Endoscopic procedure (procedure)| done by SI in October 2024. These changes seem to be in line with the update to the SI editorial guide, which states:
In all endoscopic procedures, a role group with Method of Inspection - action (qualifier value) + Using Device is mandatory. For endoscopies that require an incision, the role group to represent the incision is required. Where an additional action is performed during an endoscopy, a third role group is modelled with the applicable action.
https://confluence.ihtsdotools.org/display/DOCEG/Endoscopy+and+endoscopic+procedure
Also, there is a procedure template on Endoscopy (procedure): https://confluence.ihtsdotools.org/display/SCTEMPLATES/Endoscopy+%28procedure%29+-+Draft
However, there are UK and SI endoscopic concepts which use the word “percutaneous” in the FSN. For example,
235159007 |Percutaneous endoscopic insertion of gastrostomy tube (procedure)|
609238007 |Percutaneous endopyelotomy (procedure)|
723818004 |Percutaneous endopyelotomy using fluoroscopic guidance (procedure)|
312341002 |Permanent percutaneous endoscopic gastrostomy (procedure)|
867531000000104 |Percutaneous endoscopic laser pyelotomy and insertion of stent using fluoroscopic guidance (procedure)|
822481000000105 |Percutaneous endoscopic laser excision of thoracic intervertebral disc (procedure)|
It is unclear from the above editorial guide or the template how to model ‘percutaneous endoscopic procedures’
We think there can be two ways to model this:
Add the relationship “Access -> Percutaneous approach” to all relevant role groups apart from the role groups about inspection and incision to insert the endoscope to the body cavity. In other words, to all role groups to represent additional actions.
No need to add “Access -> Percutaneous approach” to any role group as the role group indicating that a skin incision is made to insert the endoscope is sufficient. This is provided other actions are done through the endoscope.
Further, there are core concepts, where recent modelling changes were done that do not align with the current editorial guide. For example,
235159007 |Percutaneous endoscopic insertion of gastrostomy tube (procedure)|
Also, the following procedures do not indicate that they are endoscopic procedures according to their modelling:
609238007 |Percutaneous endopyelotomy (procedure)|
723818004 |Percutaneous endopyelotomy using fluoroscopic guidance (procedure)|
The literature indicates that these are endoscopic procedures:
https://www.nice.org.uk/guidance/ipg325/chapter/2-The-procedure
https://ajronline.org/doi/pdf/10.2214/ajr.151.3.515
https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Endopyelotomy.pdf
https://www.baus.org.uk/patients/information_leaflets/187/endopyelotomy_laser
Questions:
How to model percutaneous endoscopic procedures
Should modelling of current core ‘endopyelotomy’ concepts be revised