Endoscopic methods of research

These methods allow you to visually examine the hollow organs and body cavities using optical instruments equipped with a lighting device.

The results of the endoscopy study can be documented using photo and video, digital technologies. Endoscopic research methods have found wide application in many fields of medicine:

• in gastroenterology( esophagoscopy, gastroscopy, duodenoscopy, colonoscopy, sigmoidoscopy, peritoneoscopy);

• in otorhinolaryngology and pulmonology( laryngoscopy, bronchoscopy, thoracoscopy);

• urology and nephrology( cystoscopy, urethroscopy, nephroscopy);

• gynecology( colposcopy, hysteroscopy);

• Cardiology( cardioscopy).

Endoscopy makes it possible to detect certain types of tumor, premalignant diseases, to carry out differential diagnostics of inflammatory and neoplastic diseases, to reveal the severity of pathological deviation and its location. If possible, endoscopy is accompanied by a biopsy with further morphological study of the material obtained.

Endoscopic technique allows such manipulations as local administration of drugs, removal of benign neoplasms of various organs, extraction of foreign bodies, stopping of internal bleeding, drainage of the pleural and abdominal cavities. This is especially important for the elderly and senile people, people suffering from various aggravating diseases, since complex traumatic operational activities are avoided.

The nurse must carefully prepare the patient for endoscopic examination. Such training includes both psychological and medicamental effects.

Psychological training consists in explaining the tasks and basic rules of behavior during endoscopy, medication - in the removal of psychoemotional stress, anesthesia, a decrease in the secretory activity of the glands, preventing the occurrence of pathological reflexes.

Devices used for endoscopic examination are complex devices equipped with auxiliary instruments, attachments for biopsy, administration of medicinal substances, electrocoagulation, transfer of laser radiation.

Rigid endoscopic devices retain their shape during the examination. The principle of operation of such devices is based on the transmission of light from a source( incandescent lamp located at the working end of the apparatus) through a lens optical system.

Flexible devices are also capable of changing the configuration of the working part in accordance with the shape of the organ being examined. The optical system of plastic fiber endoscopes is similar to lens, but the supply of light and image is realized by optical fibers. Thus, the lighting system is moved beyond the endoscope, which allows for sufficient illumination of organs without heating the tissues.

Rigid endoscopes equipped with fiber optics( thoracoscope, mediastinoscope, laparoscope, cystoscope, rectoscope), are structurally simplified, and safety of research is increased.

After the survey, the working part of the endoscope and its channels must be washed, cleaned and dried. Sterilize endoscopes in special chambers in pairs of certain drugs that have antimicrobial properties( ethylene oxide, formalin, etc.).Plastic endoscopes are subjected to special treatment in certain antiseptic substances( ethyl alcohol, formic alcohol, etc.).

Classify endoscopic devices into the following categories:

• by appointment( viewing, biopsy, operating);

• age modifications( for children and adults);

• structural features of the working part( rigid, flexible).

Examination of the esophagus, stomach and duodenum

Carried out with a diagnostic and / or therapeutic purpose for diseases of the esophagus, stomach, duodenum.

Contraindications to the conduct of this study:

• cicatricial changes in the esophagus;

• Traumatic injuries:

- esophagus;

- stomach;

- duodenum.

A nurse in advance instructs the patient about the appointment, time and place of the study. The study is performed on an empty stomach, you can not take food, water, medicine, smoking. A nurse accompanies the patient to the endoscopy room. The patient should carry a towel.

Colonoscopy

Colonoscopy is performed with a diagnostic and / or therapeutic purpose in the presence of probable pathologies of the large intestine. Contraindications include traumatic injuries of the intestine, cicatricial changes in the rectum.

Instruction of the patient is carried out three days before the study:

• exclude from the diet foods rich in fiber( legumes, fresh milk, black bread, fresh vegetables and fruits, dishes from potatoes);

• one day before the study, exclude hard food;

• also a day before the study, the patient is given laxatives( castor oil 60-80 ml, magnesium sulfate 125 ml of 25% solution, decoction of Senna - 140 ml);

• the night before, two cleansing enemas with a volume of about 3 to 5 hours are performed;

• In the morning, two cleansing enemas of 2.5-3 liters are prescribed, but no later than 2 hours before the procedure.

Bladder research

Cystoscopy is used for diagnostic and / or therapeutic purposes in cases of bladder diseases. Contraindications to this study: traumatic injuries of the urethra, scar changes of the urethra.

The nurse in advance supplies a sterile kit for cystoscopy:

• a cystoscope;

• the syringe of Janet;

• syringes;

• Rubber catheters;

• napkins;

• towel;

• two pairs of rubber gloves;

• Vaseline oil or glycerol;

• tweezers;

• two trays;

• gauze tampons;

• Masks;

• oilcloth;

• antiseptic solution;

• anti-shock kit;

• containers with disinfectant solution.

The patient is notified in advance of the time and place of the study.

The procedure is as follows:

• the nurse puts on sterile gloves;

• the antiseptic solution treats the patient's external genitalia;

• removes gloves and places them in a tank with disinfectant solution;

• produces a catheterization of the bladder;

• provides the doctor with a cystoscope and optics, connects the light guide;

• after disinfection of cystoscopy, disinfects tools and workplace.

When carrying out endoscopic manipulations, there is a possibility of complications, which are usually associated with a violation of the rules of preparation and implementation of the procedure. Especially serious complications: perforation of the organ under examination, bleeding from it, aspiration of gastric contents. Prevention of the development of complications is the strict observance of the rules for the preparation and implementation of endoscopic research.