Flexible gastrointestinal endoscopy is the best means for evaluation of the GI tract and is a well accepted diagnostic procedure. The ability to directly examine and biopsy the lumen of the GI tract has improved our diagnostic approach.
The typical endoscope consists of an insertion tube, a hand piece and an umbilical cord that is attached to the light source. The bending section of the endoscope is the last few centimeters and is controlled by the defluxion nubs in the handpiece.
The handpiece contains the defluxion knobs, the outer smaller knob controls the left, right and the larger knob control the up – down position. Also in the handpiece are two valves. The lower valve is the air/water valve. The upper valve is the suction valve and the finger occludes the air valve insufflations occurs. When the air valve is pressed, it activates irrigation. The upper valve activates suction. The lower opening on the handpiece is the biopsy channel. The biopsy channel and suction channel are the same. Consequently, suction cannot be applied when biopsy instruments are within the channel. Most endoscopes have a lacking device for the bending section. The endoscope should be in the free position so that the bending section easily moves.
The endoscope is designed to be held in the left hand. The index finger controls the valves. The thumb controls the up – down position, the right hand controls the left – right portion and is also used for advancing the insertion tube. The biopsy forceps are passed and held in the right hand, spreading the fingers and thumb apart opens the biopsy forceps. When the finger and thumb are closed, the biopsy forceps will close.
The endoscope should be stored hanging in a protected area. It should not be stored in the suitcase in which came in. The endoscope should be properly setup before each endoscopy. The umbilical cord is first attached to the light source. When using a video endoscope, the umbilical cord is attached to the video processor. The water bottle is next attached to the umbilical cord. Distilled water should be used for irrigation. A standard section unit is used in the endoscopy. The suction unit is attached to the umbilical cord. Once all the attachments are made and the endoscope working properly with the light turned on, it should be white balance. White balancing gives an accurate color to the endoscopic view.
The goal of this video is to demonstrate proper handling techniques and to provide normal endoscopic anatomy of the dog. Performing an endoscopy is gained only through considerable practice and recognition of a normal anatomic structures. Several precaution should be taken to avoid endoscope damage. First, a Ma Speculum should always be used. Second, one should avoid sharp bending or twisting of the endoscope. And lastly, the animal should have adequate anesthesia. If the patient is light, the endoscope should be rapidly removed to avoid damage.
Your technician is very important in endoscopy. The technician should monitor the patient to assure adequate anesthesia and also to detect over distention of the bowel with insufflated gas. With the patient under a general anesthesia and with a secured endotracheal cough, a Ma Speculum is placed prior to the endoscopic procedure. The endoscope is then lubricated and advanced through the oral cavity. For a proper orientation, the endoscopy should stand straight on to the patient and advance the scope with their right hand. Basic indications for evaluation of esophageal disease include regurgitation, dysphasia, salivation, or a change in appetite. Common esophageal conditions diagnosed include foreign bodies, strictures, esophagitis and neoplasia. The endoscope should then be advanced directly into the proximal esophagus. There should be no resistance to endoscope passage.
This shows the endoscope passing through the oral cavity, pharynx and then upper esophageal sphincter. A normal collapsed esophagus should have longitudinal folds. Esophagus is distended with air and the tip of the endoscope is capped in the center of the lumen as the scope is
Transcription by:
Scribe4you Transcription Services