Advertisement

Techniques of Upper Endoscopy

  • Thadeus L. TrusEmail author
Chapter

Abstract

An increasingly central component to the practice of general surgery is flexible endoscopy. At least half of the practicing surgeons in the USA depend on basic upper and lower endoscopy for a substantial portion of their practice. In fact, outside of most urban centers, the burden of providing endoscopy falls entirely on the general surgeon. Many common surgical disease treatments have already shifted, or are rapidly shifting towards less invasive approaches which increasingly include interventional flexible endoscopic procedures. A brief look in the recent past underlines this fact. Common bile duct exploration, pancreatic pseudocyst drainage, colectomy for benign or early neoplasia, and esophagectomy for Barrett’s disease are but a few of the conditions that are now treated endoscopically instead of surgically. As this trend continues, surgeons unskilled in flexible endoscopy will find themselves increasingly cut out of the treatment of these diseases.

Keywords

Percutaneous Endoscopic Gastrostomy Esophageal Mucosa Eosinophilic Esophagitis Common Bile Duct Exploration Esophageal Intubation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 16.1

Asking the patient to swallow often opens the cricopharyngeal sphincter briefly allowing easy passage of the scope (MOV 4770 kb)

Video 16.2

Hiatal hernia size (distance from Z-line to crus) is roughly measured from this point (MOV 4553 kb)

Video 16.3

The lesser curve should be “hugged” by the scope as one advances towards this landmark which leads the endoscopist towards the antrum and pylorus (MOV 7770 kb)

Video 16.4

Hiatal hernias are easily seen in this view and it is critical in evaluating fundoplication integrity (MOV 6746 kb)

Video 16.5

The duodenum can be carefully inspected during slow withdrawal (MOV 10621 kb)

References

  1. 1.
    ASGE Guideline. Appropriate use of GI endoscopy. Gastrointest Endosc. 2012;75(6):1127–31.CrossRefGoogle Scholar
  2. 2.
    Guideline ASGE. Complications of upper GI endoscopy. Gastrointest Endosc. 2002;55(7):784–93.CrossRefGoogle Scholar
  3. 3.
    Lieberman DA, Wuerker CK, Katon RM. Cardiopulmonary risk of esophagogastroduodenoscopy: role of endoscope diameter and systemic sedation. Gastroenterology. 1985;88:468–72.PubMedGoogle Scholar
  4. 4.
    Hart R, Classen M. Complications of diagnostic gastrointestinal endoscopy. Endoscopy. 1990;22:229–33.PubMedCrossRefGoogle Scholar
  5. 5.
    Bell GD. Premedication and intravenous sedation for upper gastrointestinal endoscopy. Aliment Pharmacol Ther. 1990;4:103–22.PubMedCrossRefGoogle Scholar
  6. 6.
    Scott-Coombes DM, Thompson JN. Hypoxia during upper gastrointestinal endoscopy is caused by sedation. Endoscopy. 1993;25:308–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Dartmouth Hitchcock Medical CenterLebanonUSA

Personalised recommendations