212INDEXred outs, 40, 114, 123, 154reflections, 8retroflexion, 46,47, 48,155retroperitoneal fixation ofdescending colon, 125retroversion of endoscope,114–15, 115retroversion snaring, 179return plate, 175reversed alpha loops, 125, 126,132,132–3,139reversed splenic flexure, 143–5,144right twist withdrawal maneuver,137,150risk assessment, 28–9, 29risk management, 33–4risk reduction, 28–9, 29rotation of view, 179Roth Net, 180safety, 87–8, 194–5salvage cytology, 55Savary–Guilliard bougies, 60, 61Schatzki ring, 50, 69sclerosants, 73sclerotherapy, 72–3, 73, 74sedation, 28, 30–2, 31, 99–100antagonists, 31–2intravenous,101–3semicritical accessories, 16septicemia, 89sequential system CCD, 8, 9sessile polyps, 183, 184,185–6, 186shaft loops, 133sigmoid colon, 120navigation through, 127,128sigmoid hand pressure, 148–9, 149sigmoid loops, 123–38anatomy, 123–5, 124, 125atypical, 132–3avoiding or minimizing, 126–7N or spiral, 129–30, 130,134push-through, 128–9, 128recognition of, 125–6sigmoid volvulus, 199sigmoid-descendingjunction,134–6, 135simethicone, 49single-handed colonoscopy,115–16, 116,157single-handed steering, 117–23,118–23slow cook, 177, 193snare handle, marking, 172snare loops, 172, 173snare wire, 173snaresbarbed, 185mini,182snaring, 67cold, 181–2pull, 179snaringin retroversion, 179sodium phosphate, 95specific hand pressure, 149specimen retrieval, 189–91spheres of activity, 2spiral loops, 129–30, 130splenic flexure, 129, 139–45anatomy, 139,140insertion around, 140–2, 140,141position change, 142reversed, 143, 144, 145split stiffening, 142, 143, 144splinting device see overtubesstaff, 1staff areas, 3staff protection, 16stance,117steering movements, 118stenosisduodenal, 67gastric, 67stentsesophageal, 64–6, 65insertion, 65post-stent management, 66sterile water supply, 18sterilization, 16Sterox, 18stiffening of colonoscope, 105,106stiffening tubes see overtubesstiffness control, 105stomachdiagnostic survey, 43–4lesions of, 51–2stomas,164–5stretch pain, 126, 128stretchers/trolleys, 12strictures, 69dilatation, 59–61, 60,61, 62submucosal lesions, 55–6, 56,161suction, 114button, 10, 17failure of, 168trap, 12, 55, 5 173, 181valves, 10suction cap EMR, 195–7, 197superior duodenal angle, 45tattooing, 173, 185, 192teaching, 5teniae coli, 111,112,121, 135,146,147tenting, 183,184terminal ileum, 155–6therapeutic colonoscopy, 172–201equipment, 172–7therapeutic endoscopy, 59–82achalasia, 62–3acute bleeding, 70–6
INDEX 213benign esophageal strictures,59–62, 60,61, 62enteral nutrition, 76–80esophageal cancer palliation,63–7foreign bodies, 68–70gastric and duodenal polypsand tumors, 67gastric and duodenal stenoses,67three-dimensional magneticimaging, 107, 108through the scope balloons, 60, 197tip control, 9, 10,39, 44tip impaction, 119tipperformation, 86toluidine blue, 53torque, 118anti-clockwise, 144,147clockwise, 118,136,141torque-steering, 118transanal microsurgery, 187transillumination, 159transverse colon, 145–9anatomy, 145–6, 145,146axis, 147insertion through, 146–8, 147,148triangular cross-section, 140,145, 146in women,145transverse hand pressure, 148–9,149transverse mesocolon, 145,146tripronggrasping device, 70tube dislodgement, 79tube placement, 199tumor destruction, 200–1tumor palliation, 200–1tuned dye lasers, 14two-handed colonoscopy, 116–17,117two-person colonoscopy, 117ulcer stigmata, 74umbilical, 7,10underwater colonoscopy, 133upper endoscopydiagnostic see diagnosticendoscopyindications for, 21–2monitoring, 30patient preparation, 22–5, 23–5recovery and discharge, 32–3risk assessment/reduction,28–9, 29risk management, 33–4risks and complications, 26–8sedation, 30–2, 31therapeutic see therapeuticendoscopyvalves of Houston, 111variable stiffness colonoscopes,105variceal banding, 73–4, 73varices, 72–4, 73video-endoscopes, 8–9color CCDs, 8, 9illumination, 9video-proctoscopy, 111, 113–14,114view, loss of, 49villous adenomas, 161virtual colonoscopy, 84volvulus, 199walking stick handle effect, 119,141water-washing, failure of, 168Z-line, 43Zenker’s diverticulum, 50Zollinger–Ellison syndrome, 52
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PracticalGastrointestinalEndoscopyT
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iiiContentsPreface to the fifth edi
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vPreface to the fifth editionOur ea
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viiAcknowledgementsPeter Cotton gra
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xINFORMATION ON THE CD-ROMScontent.
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2CHAPTER 1FACILITIESThe modern endo
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6Practical Gastrointestinal Endosco
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8CHAPTER 2FiberscopesFig. 2.2-Total
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18CHAPTER 2• Clean all instrument
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32CHAPTER 3AntagonistsMeperidine®
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