First Year Fellows Endoscopy Course (August 7 - 8) | 2022-2

2_How to Guide to Upper Endoscopy

Pdf Summary

This document is a how-to guide for performing upper endoscopy, specifically targeted towards first-year fellows. It begins with an overview of the objectives, indicating that the guide aims to provide an understanding of indications for upper endoscopy, review the technique basics, outline the components of a normal examination, and familiarize readers with abnormal conditions.<br /><br />The indications for upper endoscopy are then discussed, including upper abdominal or GI symptoms, dyspepsia, new onset GERD, persistent vomiting, dysphagia, iron deficiency anemia, suspected upper GI bleeding, esophageal varices, abnormal imaging, and food impaction or caustic ingestion. Alarm symptoms such as unintentional weight loss, odynophagia, dysphagia, hematemesis/melena, refractory acid reflux, and persistent vomiting are also noted.<br /><br />The guide emphasizes the importance of competency in both technical and cognitive skills and provides recommendations for preparing for a successful procedure, including reviewing prior procedure records and practicing a deliberate, systematic approach. Ergonomics are also discussed to ensure the comfort of the endoscopist during the procedure.<br /><br />The step-by-step technique for performing upper endoscopy is then outlined, including insertion of the endoscope, examination of the esophagus, stomach, and duodenum, and techniques such as retroflexion. Tips and considerations for each step are provided, such as the importance of proper sedation, direct visualization, and avoiding over insufflation.<br /><br />The document concludes with a recap of the key points discussed, emphasizing the need for a deliberate, systematic approach, the use of torque and body positioning to direct the scope, and the importance of practice in improving skills.

Keywords

upper endoscopy

how-to guide

indications

abnormal conditions

competency

technique basics

systematic approach

sedation

direct visualization

practice skills