First Year Fellows Endoscopy Course (August 7 - 8)

5-Tools of the Trade

Pdf Summary

This document provides information on the tools used in endoscopy procedures. It explains the anatomy of the scope, including the insertion tube, bending section, and various channels for air, water, and suction. The use of CO2 instead of room air is discussed, as it is cleared from the colon faster and can result in improved patient satisfaction and fewer complications. The sizes and diameters of different types of endoscopes are provided, emphasizing the importance of knowing these specifications for each scope used. Before starting an endoscopy, it is essential to check that the air/water and suction systems are working, the image is visible on the screen, and the irrigation is connected and functioning properly. The most frequently used devices in endoscopy are mentioned, including biopsy forceps, polypectomy snares, retrieval baskets/nets, injection needles, and clips. Techniques for obtaining adequate biopsies are discussed, such as using larger forceps, positioning them en face, and repeating biopsies if necessary. The benefits of larger forceps and the use of a central spike are explained. Snare polypectomy techniques, including hot and cold methods, are mentioned, along with the use of saline lift. Retrieval nets are described as soft, flexible meshes used to remove polyps, food, and foreign bodies. Injection needles are used for submucosal injections and can be used for various indications. Different types of injection needles are discussed, including differences in gauge, length, and adjustability. Endoclips are mechanical compression devices used for various purposes, such as controlling bleeding and closing defects. Different types of endoclips are described, including their differences in jaw opening and ability to reopen or rotate. Techniques for deploying endoclips are explained, including the need to position the clip close to the scope and engage both wings.

Keywords

endoscopy procedures

anatomy of the scope

CO2

colon

patient satisfaction

complications

biopsy forceps

polypectomy snares

injection needles

endoclips