Endoscopic operation methods

1. Subject Preparation

The subject should be well-prepared, ensuring they are fasting for the examination. Provide appropriate guidance, such as psychological comfort and instructions on the examination position.

2. Holding the Endoscope

(1) Hold the operating part of the endoscope with your left hand and the insertion tube with your right hand. The index and middle fingers of your left hand should be able to operate the air/water injection and suction buttons, and your thumb should operate the up/down bending wheel.

(2) Have the subject hold the bite block, then observe while inserting the distal end of the endoscope into the pharynx from the oral cavity. When operating the left/right bending wheel or locking the angle, use your right hand. It is essential to use a bite block to prevent the subject from accidentally biting the insertion tube.

3. Insertion and Observation

(1) Inserting the Endoscope.

Apply water or a water-soluble medical lubricant to the insertion tube, being careful not to apply it to the distal end. Gently insert the endoscope into the mouth. If a "red ball" (a diffuse red image appears when the distal end of the endoscope touches the gastric wall) appears during the procedure, slowly retract the endoscope until the gastric cavity is visible again. When a "red ball" appears, do not advance the endoscope further, as excessive force may cause gastric wall perforation.

(2) Adjusting Brightness.

Adjust the light source brightness to achieve the most comfortable illumination.

If using an argon light source, the distal end of the endoscope may become hot. Prolonged direct contact may cause mucosal thermal damage. Always use the minimum necessary light output.

(3) Bending and Locking Operations.

Operate the bending wheel as needed to guide the bending section for observation. Use your left thumb to rotate and fix the up/down bending knob. Use your right hand to operate the left/right bending knob. The bending angle can be locked using the locking knob. Generally, the locking knob (F) should be in the relaxed position. If the bending control mechanism loses its function, or if any abnormality is felt during operation, stop the examination immediately, set the bending wheel to the middle (central) position, and carefully withdraw the endoscope while observing. If you feel any unusual resistance when rotating the bending wheel, do not force it to bend further. Develop the habit of slowly operating the bending wheel.

(4) Suction.

When observation is difficult due to impurities, use suction to remove them. Suction can also be used to clear any fluid from the gastric cavity. Avoid aspirating the mucosa into the suction port; if this occurs, stop suction immediately, slightly retract the endoscope, and allow the mucosa to detach from the suction port.

(5) Cleaning the Lens. Mucus or blood accumulated on the lens surface will blur the image. Repeatedly use the air/water injection button to flush the lens surface and clean it. If there are water droplets on the lens surface, repeatedly inject air to remove them.

(6) Adjusting Air in the Gastric Cavity. As needed, inject or aspirate air to allow sufficient space in the stomach for endoscope insertion and observation. Do not over-inflate. Over-inflation may cause patient discomfort and potential harm.

4. Biopsy

(1) While observing the suspicious area requiring a biopsy, close the distal end cap and insert the biopsy forceps into the channel.

(2) Hold the biopsy forceps about 3 cm from the channel opening and advance them slowly with short, repeated movements. The biopsy forceps will enter the field of view.

(3) Open and close the distal end cap of the biopsy forceps to collect the tissue sample. Do not apply excessive force.

(4) Finally, with the cap closed, slowly withdraw the biopsy forceps from the channel.

5. Withdrawing the Endoscope

(1) Press the suction button to remove air accumulated in the stomach.

(2) Confirm that the locking knob is in the relaxed position.

(3) Confirm that the endoscope is largely straight (the bending wheel is in the middle position).

  (4) While observing through the endoscope, slowly withdraw it.

This information is sourced from the internet. Please contact us for removal if there is any infringement.