1887

Endoscopy

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Abstract

Flexible endoscopy has been used for many years for investigation of the respiratory and gastrointestinal tracts, and in recent years rigid endoscopy has become much more widely used for routine procedure in general practice. This chapter assesses equipment, purchasing options and managing the endoscopy service.

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Figures

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10.1 The grey trolley houses endoscopy equipment with two monitors, electronic insufflator, image capture system, xenon light source, camera system and printer. The blue trolley contains equipment for electrosurgery.
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10.2 Diagram of flexible endoscope. (Reproduced from the )
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10.3 A flexible duodenoscope, showing the tip flexed at 180 degrees.
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10.4 Bronchoscope handpiece with a lever to operate the two-way flexible tip.
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10.5 Images of a cat’s oesophagus. With a fibreoptic flexible endoscope, pixellation can be reduced by using a filter system in the camera, but the image is still less sharp. Image quality is considerably better with a video-endoscope.
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10.6 Examples of ancillary equipment for flexible endoscopes. Biopsy forceps – oval perforated cup with serrated edge; basket forceps; cytology brush; grasping forceps; loop snare; rat-toothed forceps.
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10.7 Rigid endoscopes with diameters 5 mm and 2.8 mm.
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10.8 Field of view of a 2.7 mm 30 degrees arthroscope. The field of view delineates the margins of the image that can be seen. The angle of view is the centre of direction of view in relation to the long axis of the endoscope. In this case the centre of the field of view is at 30 degrees to the long axis.
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10.10 Video camera connected to console. Rigid endoscopy camera connected to console.
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10.11 Using a camera adapter for a flexible endoscope. Camera adapter and endoscope handpiece. Adapter in place on oculus of handpiece. Camera attached to handpiece with adapter.
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10.12 A gridded table is useful for collecting saline and fluids during rhinoscopy, otoscopy or cystoscopy. A rotating cradle is useful for moving the patient during laparoscopy, to allow gravitational movement of abdominal contents away from the operative field.
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10.13 Cold sterilization bath with removable tray, suitable for rigid instruments.
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10.14 Typical theatre set-up to show positioning of endoscopy trolley and and electrosurgery units, and space required for equipment.
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10.15 Close-up of a flexible endoscope lens, showing wear and tear.
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10.16 A cleaning bath for flexible endoscopes.
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10.17 Storage of flexible endoscopes.
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10.18 A plastic bath is suitable for rigid endoscopes.
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10.19 A storage box suitable for rigid endoscopes.

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Examples of SOPs

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