List of Video Clips viii
Preface to the Eighth Edition x
Preface to the First Edition xi
Acknowledgments xii
About the Companion Website xiii
1 Welcome to Endoscopy 1
Resources and links 4
2 The Endoscopy Unit Staff and Management 6
Endoscopy units 6
Staff 9
Management behavior and teamwork 10
Documentation and quality improvement 10
Educational resources 11
Further reading 11
3 Endoscopic Equipment 13
Endoscopes 13
Endoscopic accessories 18
Ancillary equipment 19
Electrosurgical units 20
Lasers and argon plasma coagulation 20
Equipment maintenance 21
Infection control 22
Cleaning and disinfection 22
Further reading 26
4 Patient Care Risks and Safety 27
Patient assessment 27
Patient education and consent 32
Physical preparation 37
Sedation/anesthesia 37
Recovery and discharge 40
Managing adverse events 40
Further reading 41
5 Upper Endoscopy: The Fundamentals 43
Patient position 43
Endoscopist position 44
Endoscope Handling 44
Passing the endoscope 45
Routine diagnostic survey 48
Stomach 50
Problems during endoscopy 56
Recognition of lesions 57
Specimen collection 62
Diagnostic endoscopy under special circumstances 65
Further reading 67
6 Therapeutic Upper Endoscopy 69
Benign esophageal strictures 69
Achalasia 73
Esophageal cancer palliation 74
Gastric and duodenal stenoses 77
Gastric and duodenal polyps and tumors 78
Foreign bodies 78
Acute bleeding 82
Enteral nutrition 90
Further reading 94
7 Colonoscopy and Flexible Sigmoidoscopy 97
History 97
Indications and limitations and alternatives 97
Informed consent 101
Contraindications and infective hazards 102
Patient preparation 103
Medication 110
Equipment—present and future 114
Anatomy 119
Insertion 125
Handling “single-handed” “two-handed” or two-person? 127
Sigmoid colon—accurate steering 131
Endoscopic anatomy of the sigmoid and descending colon 134
Sigmoid colon—the bends 137
Sigmoid colon—the loops 137
Diverticular disease 145
Descending colon 147
Splenic flexure 148
Transverse colon 152
Hepatic flexure 156
Ascending colon and ileo-cecal region 158
Overtubes and balloon colonoscopy 165
Examination of the colon 165
Stomas 174
Pediatric ileocolonoscopy 174
Per-operative colonoscopy 175
Further reading 176
8 Therapeutic Colonoscopy 179
Equipment 179
Principles of polyp electrosurgery 182
Approach to polypectomy 185
Selection of polypectomy technique 187
Polypectomy: Diminutive and small polyps 187
Polypectomy: Large polyps 191
Polypectomy: Problem polyps 198
Recovery of polypectomy specimens 200
Risks of polypectomy 202
Other therapeutic procedures 205
Further reading 208
9 Advanced Endoscopic Procedures 211
Small bowel endoscopy 211
Endoscopic retrograde cholangiopancreatography (ERCP) 212
Endoscopic ultrasound (EUS) 212
Bariatric endoscopy 212
Anti-reflux procedures 213
Third space procedures and NOTES 213
Epilogue: The Future? Comments from the Senior Authors 214
Index 216
