Endoscopey Flashcards
what are the different types of endoscopy in practice?
gastroscopy
bronchoscopy
colonoscopy
esophagoscopy
urethrocystoscopy
tracheoscopy
arthroscopy
laparoscopy
otoscopy
rhinoscopy
what can we do by endocopy?
visualise masses, foreign bodies, mucosa, inflmation etc
- allows for diagnostics
perform biopsies and cytology
- for lab tesing
can assist with feeding tube placements
- PEG tube
what are the features of an endoscope?
umbilical cord, handpiece, insertion tube
light source
insufflation
irrigation
suction
monitor
diameter
- varies from 1mm-14mm
- must be >2mm to have accessory channel and deflective tip
length
- 55-170cm
- use >125 in large breed dogs
what are the features of the insertion tube on an endoscope?
fibrinogenic glass bundles (fiberscope) or CCD chip (videoscope)
biopsy/suction channel
irrigation/insufflation channel
- allow to keep lens clean
defection control cables
- see 360 degrees
- control direction
what are the features of the hand piece?
accessory channel entrance
- allows for insertion of biopsy forceps
water for irrigation
direction dials
- up/down and left/right controls
controls for water, suction and inflation
what are the types of endoscopes?
which procedures are they used for?
flexible
- bronchoscopy
- colonoscopy
- esophagoscopy
- gastroscopy
- male dog urethrocystoscopy
- nasopharyngoscopy
- tracheoscopy
rigid
- arthroscopy
- female urethrocystoscopy
- laparoscopy
- otoscopy
- rhinoscopy
- thoracoscopy
what is the purpose of rigid endoscopes?
allow for internal structures within the body cavity
evaluation of non-tubular structures
- eg body cavity or joint spaces
features of rigid endocopes?
metal outer casing
glass optic lenses
optic fibres
diameter
- vary from 10-35cm
- use largest possible to maximise light and field of view
viewing angles
- dependent - manage 0-120 degrees
sheath/cannula
- channel for diagnostic/surgical instruments or management of gas/fluid
types of flexible endoscopes?
fiberscope
- have an eyepiece for visualisation
- less space needed
- increased portability
- cheaper
- reduced video quality
- breakage of fibres leading to blackspots
videoscope
- video linked to screen/display
- far better image quality
- no risk of broken fibres as better control due to better visualization
- allows you to save images - use again for staff/owners/education
- larger screen - more people involved
what are the features of the light source on an endoscope?
connected via umbilical cord to endoscope
xenon light sources are used for videoendoscopy
always have a spare
what are the features of insufflation?
essential for GI endoscopy to maintain open lumen
used to inflate abdomen, bladder or joints
use carbon dioxide
- better control rate and air pressure
- lower risk of air embolism when inflating
usage is painful
- only use min needed
- make sure all removed afterwards
- over-inflation caused hypoventilation and puts pressure on diaphragm and vena cava
what are the features of irrigation?
positive pressure forced fluid through insertion tube
- allow to clean the lens and improve visualisation
must be distilled water
- otherwise causes mineralisation
what are the features of suction?
allows you to
- remove fluid or debris obscuring view
- remove air at end of the procedure
- remove air if patient becomes respiratory compromised
what are the features of the monitor?
image is transmitted to a monitor
- single chip (CCD) or 3 chip (3 CCD) for high res.
how do you look after the accessory channel?
don’t pass instrument through a deflected tip
- damage instrument and endoscope
don’t force an instrument if there is a resistance
- stop, pull back, work out issue
ensure instrument diameter doesn’t exceed channel diameter
how do you handle endoscope?
left hand:
- index finger - suction valve
- middle finger - irrigation and insufflation valve
- thumb - control deflection knobs
fight hand:
- insertion tube
how to clean and care for an endoscope?
do not
- drop (esp. tip)
- bend excessively
- leave over doors
- pack wet
- drown them
quick clean
- wipe clean as soon as finish
- leak test - prevents damage
- flush accessory channel with enzymatic cleaner - don’t leave long as corrodes rubber and glue
- rinse with distilled water
- dry with air - using a large syringe
okay between non-infectious GI procedures
how do you sterilise an endoscope
rinse with cold water
dry with sterile towels
gas sterilisation
- ethylene oxide
how to sort out an endoscope at the end of the day?
immerse in enzymatic cleaner for 10-15mins
flush and clean channel using brushes
rinse in distilled water
hang scope to dry - no doors!
store scopes:
- flexible - hanging
- rigid - protective case
how would you prep a patient for different endoscopies?
what are the different risks/complications?
Laproscopy
- prep same as bitch spay - larger margins
- setting up means longer GA than normal spay
- distended abdomen high risk
gastroscopy
- must be starved 6hours prior
- blocked - regurge risk
- numbing/analgesia necessary
colonoscopy
- enemas and cleanprep prior
- clean GI tract necessary
- blockage - regurge risk likely
arthroscopy
- analgesia +++
- very high infection risk - sterility necessary
rhinoscopy
- small space - correct sized endoscope
- GA monitoring around face - lots of people
- epistaxis likely
esophagoscopy
- likely FB stuck - eg animal bones
- starve as soon as know block
- regurge very likely
- hard to repair
bronchoscopy
- hypoxic likely - obstructing lungs
- likely have lung disease - compromised
cystoscopy
- very high infection risk
- small/delicate area - bleeding and damage likely
- dorsal recumbency - pressure on diaphragm/lungs
what are the risks of a badly prepped patient for endoscope?
bad imaging
infection
can’t diagnose
