Categories: ACQUIRING SKILL
Sources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The fundamental principles of peroral
endoscopy are best taught on the cadaver. It is necessary that a
specially prepared subject be had, in order to obtain the required
degree of flexibility. Injecting fluid of the following formula worked
out by Prof. J. Parsons Schaeffer for the Bronchoscopic Clinic
courses, has proved very satisfactory:
Sodium carbonate--1 1/2 lbs.
White arsenic--2 1/2 lbs.
Potassium nitrate--3 lbs.
Boil until arsenic is dissolved. When cold add:
Carbolic acid 1500 c.c.
Glycerin 1250 c.c.
Alcohol (95%) 1250 c.c.
For each body use about 3 gal. of fluid.
The method of introduction of the endoscopic tube, and its various
positions can be demonstrated and repeatedly practiced on the cadaver
until a perfected technic is developed in both the operator and
assistant who holds the head, and the one who passes the instruments
to the operator. In no other manner can the landmarks and endoscopic
anatomy be studied so thoroughly and practically, and in no other way
can the pupil be taught to avoid killing his patient. The
danger-points in esophagoscopy are not demonstrable on the living
without actually incurring mortality. Laryngeal growths may be
simulated, foreign body problems created and their mechanical
difficulties solved and practice work with the forceps and tube