96

Surglcol Procedures lncluding Minimol Access Procedures

Gostrointestinol Surgery

P/

nipulations for diagnosis and treatment are performed'

The scope is removed'

SpeciolNotes
Check with surgeon regarding topical anesthesia. Gloves are worn. Protective goggles should be worn. Pass forceps in the closed position, and guide them

Preporotion of ths Potient

The patient is supine with shoulders even with or a little over the breali at the head of the table to permit lowering of the head. Anesthesia is usually topical with sedatiSn and./or analgesia administered intravenously by the anesthetist. See Bronchoscopy, pp' 246-249, for topical anesthesia traY.

into the scope as requested.

avoid damaging cells.

Remove specimens from forceps

with a needle to

Droping

Hold aspirating tubes upright, and pinch off suction tubing as necessary to prevent aspiration of specimen. Careful labeling and handling of specimens is essen':al. (Have several labels and requisitions ready.)
ASTROSCOPY Definition
Endoscopic visualization of the stomach ancl proximal

Patient may be covered with a drape sheet' A drape

sheet covers the back table, Skin Preporotion None.

duodenum.
Discussion

Equipment Fiberoptic light source

Suction

lnstrumentotion

Gastroscopy is performed for diagnosis, aspiration of gastric contents, removal of a foreign body, or tissue biopsy. Flexible fiberoptic gastroscopy is usually performed in the gastrointestinal (GI) laboratory or at the patient's bedside. For percutaneous gastrostomy, which is aided by the passage of a fiberoptic gastroscope. see Gastrostomy, pp. 114-115.

Fiberoptic esophagoscope, suction, - biopsy forceps,

gres

.pottg" carriers, grasping forceps, dilators, and bou'

Reporotion of the Potient, Preporoiion. ond Droping

See Esophagoscopy, p. 96.

Skin

Fiberoptic light cord

Supplies

Equipment
Electrosurgical unit

Small basin (with saline and syringe) Lubricating jelly Bronchoscopy sponges (on carrier)

Fiberoptic light source

Suction

Aspitating tubes (e.g., Leuken's)

Specimen containers Needle, e.g.,25 gauge (to remove biopsy) Suction tubing Topical anest[etics (as for Bronchoscopy, pp.246-249)

lrstrumentotion
Rigid fiberoptic gastroscope, suction-electrocoagulator and cord, biopsy forceps, grasping forceps, cautery Fiberoptic light cord