Esophagoscope.

Dr. O’ Shea’s Tutorial.Valmiki Seecheran.

Surgery Senior Clerkship.

UWI Cave Hill | Class of 2015.

Esphagoscope.

Description.

• Metal tube.

• Long Handle.

• Long shaft with no distal fenestrations.

• 2 proximal ports for suction and visualization.

Indications.

• Diagnostic.• Tumor in prox 1/3 & mid 1/3 esophagus.• Cause of GI bleeding?• Esophagitis.• GERD.• Hiatal hernia.• Chest pain.

• Therapeutic.• Foreign body removal.• Stricture dilatation.• Sclerotherapy.

Contraindications.

• Absolute.• Hemodynamic instability.

• Failure to obtain consent.

• Perforation present.

• Relative.• Anticoagulopathies.

• Head & neck surgery.

• History of previous intolerance to procedure.

Technique.

• Full history & examination.

• Focus on oral cavity and pharynx, thyroid gland, cervical and supraclavicular lymph nodes.

• Gain consent.

• Position patient in left lateral decubitus position.

• Moderate sedation – narcotic + benzodiazepine.

• Scope is inserted into the oropharynx with visualization of epiglottis and vocal cords.

• The scope is advanced through piriformis sinuses and esophageal lumen.

• Air insufflation is used to distend esophageal lumen.

Complications.

• Bleeding.

• Infection.

• Perforation.

• Aspiration.

• Over sedation.

• Hypoventilation.

• Cervical sepsis.

• Dental injury.

Thank you.