What are the clinical applications of endoscopy?
- FB removal. - Bronchoscopy. - GI tract investigations. - BAL (Bronchio alveolar lavage). - Oesophagus investigations (megaoesophagus). - Biopsies. - Ex-lap. - Airway ops. - Colonoscopy. - To help intubate (EQ). - Arthroscopy. - Laproscopic spays. - Tenoscopy (Look at tendons, EQ). - Cystoscopy. - Rhinoscopy. - Dentals.
- Trying to look at an area without making an incision.
What are the features of a basic endoscope?
- Hand piece.
- Control centre.
- Insertion tube.
What is the hand piece for?
- Is the entrance to the accessory channel.
- Suction/insufflation valves are on here.
- Water for washing the lens is here too.
What is the control centre on the hand piece for?
- Directional aids to guide the endoscope.
- Controls for water, suction and inflation.
- Entrance hole for introduction of accessories.
What is the insertion tube?
- the tube that is inserted into the patient.
What are the 2 types of endoscope?
- Rigid
- Flexible
What sort of things would you use the flexible endoscope for?
- Airways, GI tract, colonoscopy, tracheal washes.
What can a flexible endoscope do that a rigid one can’t?
- Turn the tip/camera end in different directions to look at other structures/areas that you may have passed.
What might you use a fixed endoscope for?
- Arthroscopy, rhinoscopy, laparoscopic spays.
What are the 2 types of flexible endoscope?
- Fiberscope
- Videoendoscope.
What are the components to an endoscope?
- Light source
- Insufflation - essential for GI endoscope to maintain open lumen for inspection.
- irrigation - Positive pressure forces fluid through the insertion tube to clean the lens.
- Suction.
- Monitor.
What do you do for handling and care with an endoscope?
- leak test.
- Wipe clean as soon as you finish with it before doing full clean.
- Flush accessory channel with enzymatic cleaner.
- rinse thoroughly.
What shouldn’t you do?
- Drop them
- Bend them
- Leave over doors
- Pack whilst wet
- Drown them
What is the main difference between a fiberscope and a videoendoscope?
- Fiberscope you can only look through the eye piece and a videoendoscope you can get a monitor and stand for or connect to laptop.
If you inflate the abdomen during endoscopy what should you do at the end of the procedure?
- Remove the air!
Where does the suction track through and removed water end up?
- tracked through the umbilical cord and ends up in the reservoirs. Remove water from reservoirs and clean.
What are some examples of instruments for the accessory channels during endoscopy?
- Biopsy forceps
- Loop snare
- Forked jaw graspers
- Raptor forceps
- Alligator forceps
What are some considerations for biopsy taking?
- Try to cause minimal trauma to the patient and sample being taken.
- Have correct preservative/pots ready and labelled.
- Can use cytology brush to get cytology sample rather than take whole sample.
What is endoscopy doubled up as?
- a diagnostic tool and a treatment option.
What is the patient prep for a gastroscope? - SA
- Starve them
- GA
- I/V access, pre-med checks for GA.
And what is the prep for equine?
- Starve them and remove water.
- Sedate them unless looking for laryngeal paralysis.
what is the patient prep for arthroscopy?
- Same as above but for equine, clip/clean and wash are before taking them to anaesthetics (doing this before GA reduces anaesthetic time).
- Remove hair etc.
What would you do to prepare for a colonoscopy?
- Give an enema/laxative before.
- Client compliance - Are they going to give this themselves before coming to practice?
What is a colonoscopy looking at?
- Colon to small intestine.
