First Year Fellows Endoscopy Course (August 4-5) | 2023-2

2_How to Guide to Upper Endoscopy

Pdf Summary

This document is a how-to guide for performing upper endoscopy, aimed specifically at first-year fellows. It starts with a disclosure statement and outlines the objectives of the guide, which include understanding the indications for upper endoscopy and becoming familiar with abnormal conditions.<br /><br />The document provides a question asking which is not an appropriate indication for upper endoscopy and gives multiple options for the answer. It then provides the correct answer and explains the appropriate indications for upper endoscopy, such as upper abdominal or upper GI symptoms, persistent reflux symptoms, dysphagia, and suspected upper gastrointestinal bleeding.<br /><br />The guide also discusses alarm symptoms that warrant an upper endoscopy, such as unintentional weight loss, dysphagia, hematemesis/melena, and persistent acid reflux.<br /><br />It emphasizes the importance of learning to perform upper endoscopy, including the minimum number of procedures that should be performed before assessing competency. It encourages a deliberate, systematic approach, taking the time to look carefully for subtle lesions, and building on basic skills for advanced procedures.<br /><br />The document also discusses ergonomics during the procedure, such as positioning the monitor directly in front of the endoscopist and ensuring the examination table is at the appropriate height.<br /><br />It provides guidance on the insertion of the endoscope, including visualizing the hypopharynx and the UES, as well as special considerations like Zenker's diverticulum. It explains how to examine the esophagus, stomach, and duodenum, and discusses the techniques for advancing and withdrawing the endoscope.<br /><br />The document concludes with a recap of the key points covered, emphasizing the need for a systematic approach, the use of torque and body positioning, and the importance of practice and continuous improvement.

Keywords

upper endoscopy

indications

abnormal conditions

dysphagia

gastrointestinal bleeding

alarm symptoms

ergonomics

endoscope insertion

esophagus examination

stomach examination