{"id":5678190,"date":"2020-12-12T10:35:40","date_gmt":"2020-12-12T09:35:40","guid":{"rendered":"https:\/\/www.dr-delagranda.com\/panendoscopie\/"},"modified":"2024-02-22T08:06:38","modified_gmt":"2024-02-22T07:06:38","slug":"panendoscopy","status":"publish","type":"page","link":"https:\/\/www.dr-delagranda.com\/en\/panendoscopy\/","title":{"rendered":"Panendoscopy"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row full_width=&#8221;stretch_row_content_no_spaces&#8221; css=&#8221;.vc_custom_1622029079692{padding-top: 35vh !important;padding-bottom: 25vh !important;background-image: url(https:\/\/www.dr-delagranda.com\/wp-content\/uploads\/2021\/05\/laryngoscope-panendoscopie.jpg?id=5676445) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221;][vc_column offset=&#8221;vc_col-lg-offset-1 vc_col-lg-10 vc_col-md-offset-1 vc_col-md-10 vc_col-sm-offset-0 vc_col-xs-12&#8243; css=&#8221;.vc_custom_1603286580076{padding-right: 12% !important;padding-left: 12% !important;}&#8221;]<div class=\"norebro-heading-sc heading text-shadow text-center\"\n\tid=\"norebro-custom-69f37b359842d\" \n\t \n\t>\n\t\n\t\n\t\n\t<h1 class=\"title\">\n\t\tPanendoscopy\t<\/h1>\n\n\t\n\t\t\n<\/div>[\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row_content&#8221; css=&#8221;.vc_custom_1621508523884{padding-top: 8vh !important;}&#8221; el_id=&#8221;pharynx&#8221;][vc_column offset=&#8221;vc_col-lg-offset-2 vc_col-lg-8 vc_col-md-offset-1 vc_col-md-10 vc_col-sm-offset-0 vc_col-xs-12&#8243;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35a2e3d\" \n\t \n\t>\n\n\t<p>Panendoscopy is mainly used to better assess a tumor, cyst or polyp when its location makes it difficult to examine in the consulting room. Panendoscopy enables a biopsy to be taken from an area that is difficult to access, so that the nature of the tumour, polyp or cyst can be determined. Cancers of the mucous membranes of the mouth, oropharynx, hypopharynx, rhinopharynx, larynx and sometimes oesophagus require a precise assessment of their extension. In addition to imaging examinations such as dental panoramas, ultrasound scans, MRIs and PET scans, it is imperative for therapeutic decisions and treatments to have a clear surface description, which panendoscopy enables. Panendoscopy is therefore mandatory at the initial stage of assessment. It is performed very rapidly to confirm the diagnosis with a biopsy, note the extent of the disease and look for any other concomitant cancer. It is usually performed under general anaesthetic on an outpatient basis.<\/p>\n<p>Find out more about panendoscopy from Dr Delagranda, an ENT surgeon in La Roche-sur-Yon in the Vend\u00e9e.<\/p>\n\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-heading-sc heading text-center\"\n\tid=\"norebro-custom-69f37b35a71cd\" \n\t \n\t>\n\t\n\t\n\t\n\t<h2 class=\"title\">\n\t\tPharynx, larynx, oral cavity, nasal cavity and upper esophagus\t<\/h2>\n\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35a72ba\" \n\t \n\t>\n\n\t<p>Panendoscopy uses specially dedicated endoscopes to observe and describe all the different parts of the body between the lips, nose and upper esophagus.<\/p>\n\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;][vc_row_inner][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;5676765&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221; onclick=&#8221;link_image&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;5676766&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221; onclick=&#8221;link_image&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;5676767&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221; onclick=&#8221;link_image&#8221;][\/vc_column_inner][\/vc_row_inner][vc_empty_space height=&#8221;40px&#8221;][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1619600626772{padding-top: 6vh !important;padding-bottom: 8vh !important;}&#8221;][vc_column width=&#8221;2\/3&#8243; offset=&#8221;vc_col-lg-offset-2 vc_col-lg-8 vc_col-md-offset-1 vc_col-md-10 vc_col-sm-offset-0 vc_col-xs-offset-1 vc_col-xs-10&#8243; css=&#8221;.vc_custom_1619534081562{border-top-width: 1px !important;border-right-width: 1px !important;border-bottom-width: 1px !important;border-left-width: 1px !important;padding-top: 10px !important;padding-right: 10px !important;padding-bottom: 10px !important;padding-left: 10px !important;background-color: #f9f9f9 !important;border-left-color: #0a0a0a !important;border-left-style: dotted !important;border-right-color: #0a0a0a !important;border-right-style: dotted !important;border-top-color: #0a0a0a !important;border-top-style: dotted !important;border-bottom-color: #0a0a0a !important;border-bottom-style: dotted !important;border-radius: 1px !important;}&#8221;]<div class=\"norebro-text-sc \" \n\tid=\"norebro-custom-69f37b35a738f\" \n\t \n\t>\n\n\t<div id=\"post-link-5678190\" class=\"sh-link post-link sh-hide\"><a href=\"#\" onclick=\"showhide_toggle('post', 5678190, 'SUMMARY', 'SUMMARY'); return false;\" aria-expanded=\"false\"><span id=\"post-toggle-5678190\">SUMMARY<\/span><\/a><\/div><div id=\"post-content-5678190\" class=\"sh-content post-content sh-hide\" style=\"display: none;\"><\/p>\n<ul>\n<li><a href=\"#pharynx\">Pharynx, larynx, oral cavity<\/a><\/li>\n<li><a href=\"#publics\">Who is concerned by panendoscopy?<\/a><\/li>\n<li><a href=\"#publics\">Objectives of panendoscopy<\/a><\/li>\n<li><a href=\"#indications\">When should a panendoscopy be performed?<\/a><\/li>\n<li><a href=\"#intervention\">Panendoscopy<\/a><\/li>\n<li><a href=\"#intervention\">Post-operative recovery period<\/a><\/li>\n<li><a href=\"#intervention\">Complications associated with panendoscopy<\/a><\/li>\n<li><a href=\"#questions\">Frequently asked questions<\/a><\/li>\n<li><a href=\"#rdv\">Appointment<\/a><\/li>\n<\/ul>\n<p><\/div>\n\t\n<\/div>[\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row&#8221; css=&#8221;.vc_custom_1621508629873{background: #ffffff url(https:\/\/www.dr-delagranda.com\/wp-content\/uploads\/2021\/04\/objectifs-panendoscopie.jpg?id=5675585) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221; el_id=&#8221;publics&#8221;][vc_column][vc_empty_space height=&#8221;120px&#8221;][vc_row_inner][vc_column_inner width=&#8221;7\/12&#8243; css=&#8221;.vc_custom_1607095018746{padding-right: 10% !important;padding-left: 10% !important;background-color: rgba(255,255,255,0.95) !important;*background-color: rgb(255,255,255) !important;}&#8221;][vc_empty_space height=&#8221;60px&#8221;]<div class=\"norebro-heading-sc heading text-left\"\n\tid=\"norebro-custom-69f37b35a79ee\" \n\t \n\t>\n\t\n\t\n\t\n\t<h2 class=\"title\">\n\t\tWho is concerned by panendoscopy?\t<\/h2>\n\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35a7ac8\" \n\t \n\t>\n\n\t<p>Adults with various ENT symptoms on the advice of an ENT doctor.<br \/>\nVery young children, often born prematurely, with laryngeal symptoms such as stridor (abnormal high-pitched noise when breathing in due to disturbed airflow in the upper airways) accompanied by difficulty in eating or breathing.<br \/>\nChildren with so-called embryonic cervical malformations, some of which result in fistulous orifices in the pharynx (Fistula of the IVth arch, for example).<\/p>\n\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-heading-sc heading text-left\"\n\tid=\"norebro-custom-69f37b35a7b5c\" \n\t \n\t>\n\t\n\t\n\t\n\t<h2 class=\"title\">\n\t\tObjectives of panendoscopy\t<\/h2>\n\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35a7c05\" \n\t \n\t>\n\n\t<ul>\n<li>Determine the appearance and local extension of a tumor or fistula<\/li>\n<li>Perform a biopsy<\/li>\n<li>Determine the effectiveness of a treatment<\/li>\n<\/ul>\n\t\n<\/div>[vc_empty_space height=&#8221;80px&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;5\/12&#8243;][\/vc_column_inner][\/vc_row_inner][vc_empty_space height=&#8221;120px&#8221;][\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row_content&#8221; css=&#8221;.vc_custom_1621508638930{padding-top: 8vh !important;padding-bottom: 8vh !important;}&#8221; el_id=&#8221;indications&#8221;][vc_column offset=&#8221;vc_col-lg-offset-2 vc_col-lg-8 vc_col-md-offset-1 vc_col-md-10 vc_col-sm-offset-0 vc_col-xs-12&#8243;]<div class=\"norebro-heading-sc heading text-center\"\n\tid=\"norebro-custom-69f37b35a7cc0\" \n\t \n\t>\n\t\n\t\n\t\n\t<h2 class=\"title\">\n\t\tWhen is a panendoscopy necessary?\t<\/h2>\n\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35a7d85\" \n\t \n\t>\n\n\t<p>A panendoscopy is indicated in cases of:<\/p>\n<ul>\n<li>Suspicion of cancer (persistent unexplained pain, persistent unexplained change in voice, bleeding, involuntary weight loss, anorexia, visible mass in the mouth, throat or neck, etc.).<\/li>\n<li>Suspicion of benign tumours, cysts, polyps inaccessible in consultation because they are too far from the mouth (example: vocal cord polyp with voice changes)<\/li>\n<li>Monitoring the effectiveness of chemotherapy treatment: by assessing the reduction in tumour size<\/li>\n<li>Assessing malformation or immaturity of the larynx or pharynx<\/li>\n<li>Suspicion of a foreign body blocked in the upper aerodigestive tract (fish bone, chicken bone, rabbit bone, pig bone, piece of plastic, paper clip, etc.).<\/li>\n<\/ul>\n\t\n<\/div>[\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row_content&#8221; css=&#8221;.vc_custom_1621508647276{padding-top: 8vh !important;padding-bottom: 8vh !important;background-color: #0f2233 !important;}&#8221; el_id=&#8221;intervention&#8221;][vc_column offset=&#8221;vc_col-lg-offset-2 vc_col-lg-8 vc_col-md-offset-1 vc_col-md-10 vc_col-sm-offset-0 vc_col-xs-12&#8243;]<div class=\"norebro-heading-sc heading text-center\"\n\tid=\"norebro-custom-69f37b35a7e08\" \n\t \n\t>\n\t\n\t\n\t\n\t<h2 class=\"title\">\n\t\tThe different stages of the intervention\t<\/h2>\n\n\t\t\t<div class=\"divider\"><\/div>\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;60px&#8221;]<div class=\"norebro-heading-sc heading text-left\"\n\tid=\"norebro-custom-69f37b35a7e9b\" \n\t \n\t>\n\t\n\t\n\t\n\t<h2 class=\"title\">\n\t\tThe surgery\t<\/h2>\n\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35a7f5e\" \n\t \n\t>\n\n\t<p>Always performed under general anaesthesia, and usually on an outpatient basis, the procedure involves inserting metal instruments (laryngoscopes, hypopharyngoscopes, esophagoscopes) through the mouth or nose to loosen the mucous membrane of the pharynx, larynx, oral cavity, nasal cavity and upper esophagus, and inserting rigid optics and biopsy forceps to visualize the tumour precisely.<\/p>\n\t\n<\/div>[vc_empty_space height=&#8221;60px&#8221;]<div class=\"norebro-heading-sc heading text-left\"\n\tid=\"norebro-custom-69f37b35a8008\" \n\t \n\t>\n\t\n\t\n\t\n\t<h3 class=\"title\">\n\t\tPost-surgery recovery period\t<\/h3>\n\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35a80e1\" \n\t \n\t>\n\n\t<p>In the case of outpatient hospitalization, the patient is discharged home on the same day as the operation.<br \/>\nThe patient is back to normal within 24-48 hours, once the anesthetic products have been eliminated.<br \/>\nTime off work depends on the pathology concerned, and may only cover the day of the operation.<br \/>\nPost-operative care at home: mouthwash, analgesics<br \/>\nScarring: no visible scarring<\/p>\n\t\n<\/div>[vc_empty_space height=&#8221;60px&#8221;]<div class=\"norebro-heading-sc heading text-left\"\n\tid=\"norebro-custom-69f37b35a8188\" \n\t \n\t>\n\t\n\t\n\t\n\t<h3 class=\"title\">\n\t\tComplications associated with panendoscopy\t<\/h3>\n\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35a827e\" \n\t \n\t>\n\n\t<p>In addition to the risks inherent in any surgery involving general anesthesia, panendoscopy presents a number of minor risks:<\/p>\n<ul>\n<li>Mouth sores, lip pinching<\/li>\n<li>Abnormal mobility of teeth (the presence of fragile teeth (bridges, implants) should be noted)<\/li>\n<li>Tooth dislocation<\/li>\n<\/ul>\n<p>More serious but exceptional risks:<\/p>\n<ul>\n<li>Severe bleeding<\/li>\n<li>Respiratory difficulties<\/li>\n<li>Digestive tract perforation<\/li>\n<\/ul>\n<p>For further information, please consult the ENT College&#8217;s explanatory sheet on panendoscopy:<\/p>\n<p><a href=\"https:\/\/www.dr-delagranda.com\/wp-content\/uploads\/2021\/05\/fiche-orl-amygdalectomie-enfant.pdf\" target=\"_blank\" rel=\"noopener\">\u2794<\/a><a href=\"https:\/\/www.dr-delagranda.com\/wp-content\/uploads\/2021\/05\/fiche-orl-endoscopie-voies-aero-digestives-superieures.pdf\" target=\"_blank\" rel=\"noopener\"> Endoscopie des voies a\u00e9ro-digestives superieures<\/a><br \/>\n<a href=\"https:\/\/www.dr-delagranda.com\/wp-content\/uploads\/2021\/05\/fiche-orl-amygdalectomie-enfant.pdf\" target=\"_blank\" rel=\"noopener\">\u2794<\/a><a href=\"https:\/\/www.dr-delagranda.com\/wp-content\/uploads\/2021\/05\/fiche-orl-extraction-corps-etranger-laryngo-tracheo-bronchique.pdf\" target=\"_blank\" rel=\"noopener\"> Extraction corps etranger laryngo tracheo bronchique<\/a><br \/>\n<a href=\"https:\/\/www.dr-delagranda.com\/wp-content\/uploads\/2021\/05\/fiche-orl-amygdalectomie-enfant.pdf\" target=\"_blank\" rel=\"noopener\">\u2794<\/a><a href=\"https:\/\/www.dr-delagranda.com\/wp-content\/uploads\/2022\/07\/fiche-orl-laryngologie-medialisation-corde-vocale-par-injection.pdf\" target=\"_blank\" rel=\"noopener\"> M\u00e9dialisation de la corde vocale par injection, pour paralysie laryng\u00e9e unilat\u00e9rale <\/a><\/p>\n\t\n<\/div>[\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row_content&#8221; css=&#8221;.vc_custom_1621508657662{padding-top: 8vh !important;padding-bottom: 10vh !important;}&#8221; el_id=&#8221;questions&#8221;][vc_column offset=&#8221;vc_col-lg-offset-2 vc_col-lg-8 vc_col-md-offset-1 vc_col-md-10 vc_col-sm-offset-0 vc_col-xs-12&#8243;]<div class=\"norebro-heading-sc heading text-center\"\n\tid=\"norebro-custom-69f37b35a832a\" \n\t \n\t>\n\t\n\t\n\t\n\t<h2 class=\"title\">\n\t\tFrequently asked questions about panendoscopy\t<\/h2>\n\n\t\t\t<div class=\"divider\"><\/div>\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;60px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35a83f2\" \n\t \n\t>\n\n\t<p>Here is a selection of questions frequently asked by Dr Delagranda&#8217;s patients during a consultation for panendoscopy in La Roche-sur-Yon.<\/p>\n\t\n<\/div>[vc_empty_space height=&#8221;60px&#8221;]<div class=\"norebro-accordion-s\u0441 accordion-box  outline\" \n\tid=\"norebro-custom-69f37b35a8495\"\n\tdata-norebro-accordion=\"0\"\n\t \n\t>\n\n\t<div id=\"1605017264328-06613f59-3c90\" class=\"item justify\">\n\t\n\t<div class=\"title\">\n\t\t\t\t<h4>Is panendocopy mandatory?<\/h4>\n\t\t<div class=\"control\">\n\t\t\t<span class=\"ion-plus\"><\/span>\n\t\t<\/div>\n\t<\/div>\n\n\t<div class=\"content\">\n\t\t<div class=\"wrap\">\n\t\t\t<p>Yes, in the case of cancer, and recommended if your surgeon suggests it.<\/p>\n\t\t<\/div>\n\t<\/div>\n\n<\/div><div id=\"1605017264387-ae52c0b0-c778\" class=\"item justify\">\n\t\n\t<div class=\"title\">\n\t\t\t\t<h4>Is it very painful?<\/h4>\n\t\t<div class=\"control\">\n\t\t\t<span class=\"ion-plus\"><\/span>\n\t\t<\/div>\n\t<\/div>\n\n\t<div class=\"content\">\n\t\t<div class=\"wrap\">\n\t\t\t<p>No, in general it&#8217;s practically painless.<\/p>\n\t\t<\/div>\n\t<\/div>\n\n<\/div><div id=\"1605017264450-ed4b6523-622c\" class=\"item justify\">\n\t\n\t<div class=\"title\">\n\t\t\t\t<h4>Fees and payment for the procedure<\/h4>\n\t\t<div class=\"control\">\n\t\t\t<span class=\"ion-plus\"><\/span>\n\t\t<\/div>\n\t<\/div>\n\n\t<div class=\"content\">\n\t\t<div class=\"wrap\">\n\t\t\t<p>Panendoscopy is covered by health insurance. Contact your mutual insurance company to find out whether any extra fees will be covered.<\/p>\n\t\t<\/div>\n\t<\/div>\n\n<\/div>\t\n<\/div>[\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row_content_no_spaces&#8221; css=&#8221;.vc_custom_1621508665657{background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221; el_id=&#8221;rdv&#8221;][vc_column parallax=&#8221;content-moving&#8221; parallax_image=&#8221;5676558&#8243; css=&#8221;.vc_custom_1622241112017{padding-top: 20vh !important;padding-bottom: 20vh !important;}&#8221;][vc_row_inner][vc_column_inner css=&#8221;.vc_custom_1619469911864{padding-right: 7% !important;padding-left: 7% !important;}&#8221; offset=&#8221;vc_col-lg-offset-2 vc_col-lg-8 vc_col-md-offset-1 vc_col-md-10&#8243;]<div class=\"norebro-heading-sc heading text-center\"\n\tid=\"norebro-custom-69f37b35b44ff\" \n\t \n\t>\n\t\n\t\n\t\n\t<h2 class=\"title\">\n\t\tDo you have a question? Need more information?\t<\/h2>\n\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;60px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35b45d0\" \n\t \n\t>\n\n\t<p>Dr Antoine Delagranda will be happy to answer any questions you may have about panendoscopy. Dr Delagranda is a specialist in ENT surgery at the Clinique Saint Charles in La Roche-sur-Yon in the Vend\u00e9e.<\/p>\n\t\n<\/div>[vc_empty_space height=&#8221;60px&#8221;]<div class=\"norebro-button-sc btn-wrap text-center\" \n\tid=\"norebro-custom-69f37b35b46a0\"\n\t \n\t>\n\n\t<a href=\"#consultation\" \n\t\tclass=\"btn  btn-outline btn-large\">\n\n\t\t\n\t\t\n\t\t<span class=\"text\">\n\t\t\tMake an appointment with Dr Delagranda\t\t<\/span>\n\n\t\t\n\t\t\n\t\t\t<\/a>\n\n<\/div>[\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row_content_no_spaces&#8221; el_id=&#8221;consultation&#8221;][vc_column offset=&#8221;vc_col-lg-offset-0 vc_col-lg-12 vc_col-md-offset-0 vc_col-md-12 vc_col-sm-offset-0 vc_col-xs-12&#8243;][vc_row_inner css=&#8221;.vc_custom_1619533987520{padding-top: 8vh !important;padding-bottom: 6vh !important;}&#8221;][vc_column_inner offset=&#8221;vc_col-lg-offset-2 vc_col-lg-8 vc_col-md-offset-1 vc_col-md-10&#8243;]<div class=\"norebro-heading-sc heading text-center\"\n\tid=\"norebro-custom-69f37b35b4e15\" \n\t \n\t>\n\t\n\t\n\t\n\t<h2 class=\"title\">\n\t\tENT consultation for panendoscopy in Vend\u00e9e\t<\/h2>\n\n\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;40px&#8221;]<div class=\"norebro-text-sc justify\" \n\tid=\"norebro-custom-69f37b35b4f00\" \n\t \n\t>\n\n\t<p style=\"text-align: center;\">Dr Antoine Delagranda will be happy to answer any questions you may have about panendoscopy. Dr Delagranda is a specialist in ENT surgery at the Clinique Saint Charles in La Roche-sur-Yon in Vend\u00e9e.<\/p>\n\t\n<\/div>[\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row_content_no_spaces&#8221; gap=&#8221;30&#8243; equal_height=&#8221;yes&#8221; el_class=&#8221;upper-layer&#8221; css=&#8221;.vc_custom_1636446388832{padding-right: 10% !important;padding-bottom: 8vh !important;padding-left: 10% !important;}&#8221; el_id=&#8221;rdv&#8221;][vc_column width=&#8221;1\/3&#8243;][vc_row_inner css=&#8221;.vc_custom_1502457070774{margin-right: 0px !important;margin-left: 0px !important;background-color: #f9f9f9 !important;}&#8221;][vc_column_inner css=&#8221;.vc_custom_1607088904656{background-color: #f7f7f7 !important;}&#8221;][vc_empty_space height=&#8221;50px&#8221;]<div class=\"norebro-icon-box-sc icon-box text-`{`object Object`}`\" \n\tid=\"norebro-custom-69f37b35b4fbe\" \n\t \n\t>\n\n\t<div class=\"icon-wrap shape-fill brand-bg-color shape-rounded\">\n\t\t\t\t\t<span class=\"linea-basic-geolocalize-01\"><\/span>\n\t\t\t<\/div>\n\n\t<div class=\"content-wrap\">\n\n\t\t<div class=\"content-center with-full\">\n\t\t\t<div class=\"wrap\">\n\t\t\t\t<h3>Medical office<\/h3>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\n\t\t\t<\/div>\n\t\t\n\t\t<p class=\"description content-full\">\n\t\t\tClinique Saint Charles<br \/>\n11 boulevard Ren\u00e9 Levesque<br \/>\n85016 La Roche-sur-Yon<br \/>\nVend\u00e9e\t\t<\/p>\n\n\t\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;50px&#8221;][\/vc_column_inner][\/vc_row_inner][vc_empty_space height=&#8221;10px&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_row_inner css=&#8221;.vc_custom_1502457070774{margin-right: 0px !important;margin-left: 0px !important;background-color: #f9f9f9 !important;}&#8221;][vc_column_inner css=&#8221;.vc_custom_1607088917620{background-color: #f7f7f7 !important;}&#8221;][vc_empty_space height=&#8221;50px&#8221;]<div class=\"norebro-icon-box-sc icon-box text-`{`object Object`}`\" \n\tid=\"norebro-custom-69f37b35b9029\" \n\t \n\t>\n\n\t<div class=\"icon-wrap shape-fill brand-bg-color shape-rounded\">\n\t\t\t\t\t<span class=\"linea-basic-calendar\"><\/span>\n\t\t\t<\/div>\n\n\t<div class=\"content-wrap\">\n\n\t\t<div class=\"content-center with-full\">\n\t\t\t<div class=\"wrap\">\n\t\t\t\t<h3>Secretary for appointment<\/h3>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\n\t\t\t<\/div>\n\t\t\n\t\t<p class=\"description content-full\">\n\t\t\t+33(0)2 51 44 44 85<br \/>\nMonday to Friday<br \/>\n9am-12pm \/ 2pm-6pm\t\t<\/p>\n\n\t\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;50px&#8221;][vc_empty_space height=&#8221;25px&#8221; el_class=&#8221;vc_hidden-sm vc_hidden-xs&#8221;][\/vc_column_inner][\/vc_row_inner][vc_empty_space height=&#8221;20px&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_row_inner css=&#8221;.vc_custom_1502457070774{margin-right: 0px !important;margin-left: 0px !important;background-color: #f9f9f9 !important;}&#8221;][vc_column_inner css=&#8221;.vc_custom_1607088929872{background-color: #f7f7f7 !important;}&#8221;][vc_empty_space height=&#8221;50px&#8221;]<div class=\"norebro-icon-box-sc icon-box text-`{`object Object`}`\" \n\tid=\"norebro-custom-69f37b35b913a\" \n\t \n\t>\n\n\t<div class=\"icon-wrap shape-fill brand-bg-color shape-rounded\">\n\t\t\t\t\t<span class=\"linea-basic-clock\"><\/span>\n\t\t\t<\/div>\n\n\t<div class=\"content-wrap\">\n\n\t\t<div class=\"content-center with-full\">\n\t\t\t<div class=\"wrap\">\n\t\t\t\t<h3>Opening hours<\/h3>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\n\t\t\t<\/div>\n\t\t\n\t\t<p class=\"description content-full\">\n\t\t\tClinic reception<br \/>\nMonday to Friday<br \/>\n8am-12.30pm \/ 1.30pm-6.30pm<br \/>\nClosed : Sat \/ Sun\t\t<\/p>\n\n\t\t\n\t\t\n<\/div>[vc_empty_space height=&#8221;50px&#8221;][\/vc_column_inner][\/vc_row_inner][vc_empty_space 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