First Year Fellows Endoscopy Course (Aug 6-7) | 2021-2

2_How to Guide to Upper Endoscopy

Pdf Summary

This document is a how-to guide for performing upper endoscopy. It begins by listing the indications for upper endoscopy, such as upper abdominal or GI symptoms, iron deficiency anemia, and suspected upper gastrointestinal bleeding, among others. It also highlights alarm symptoms that should prompt immediate evaluation. <br /><br />The guide emphasizes the importance of learning the technique and building both technical and cognitive skills. It suggests being prepared for each case and reviewing the patient's medical history. Ergonomics and positioning while performing endoscopy are also discussed, with recommendations for monitor position and table height. <br /><br />The document then describes the technique for inserting and maneuvering the endoscope through the gastrointestinal tract. It advises on visualization of the hypopharynx, vocal cords, and UES. The guide emphasizes the importance of a systematic approach and careful examination, as well as taking one's time to look for subtle lesions. It also highlights the need for proper sedation and direct visualization during the procedure. <br /><br />The document provides detailed instructions on examining the esophagus, stomach, and duodenum. It covers techniques for entering the stomach, examining the stomach body and pylorus, and traversing the pyloric channel. It also explains the examination of the duodenum, including the bulb and descending and transverse portions. The guide mentions the importance of retroflexion to examine the incisura, cardia, and fundus of the stomach during withdrawal of the endoscope. <br /><br />Finally, the document discusses when and where to perform biopsies and emphasizes the importance of keeping the pathologist informed. It concludes with a recap of the technique and a reminder to develop and practice a systematic approach to improve skills.

Keywords

upper endoscopy

indications

cognitive skills

ergonomics

visualization

sedation

esophagus

stomach

duodenum

biopsies