Instrumentarium
-
Asepsis
Strict aseptic technic must be observed in all endoscopic procedures. The operator, first assistant, and instrument nurse must use the same precautions as to hand sterilization and sterile gowns as would be exercised in any surgical operation. The o... Aspirating Tubes
Independent aspirating tubes involve delay in their use as compared to aspirating canals in the wall of the endoscopic tube; but there are special cases in which an independent tube is invaluable. Three forms are used by the author. The velvet eye ... Batteries
The simplest, best, and safest source of current is a double dry battery arranged in three groups of two cells each, connected in series (Fig. 8). Each set should have two binding posts and a rheostat. The binding posts should have double holes for ... Bronchial Dilators
It is not uncommon to find a stricture of the bronchus superjacent to a foreign body that has been in situ for a period of months. In order to remove the foreign body, this stricture must be dilated, and for this the bronchial dilator shown in Fig. ... Bronchoscopes
The regular bronchoscope is a hollow brass tube slanted at its distal end, and having a handle at its proximal or ocular extremity. An auxiliary canal on its under surface contains the light carrier, the electric bulb of which is situated in a reces... Bronchoscopic And Esophagoscopic Grasping Forceps
are of the tubular type, that is, a stylet carrying the jaws works in a slender tube so that traction on the stylet draws the V of the open jaws into the lumen of the tube, thus causing the blades to approximate. They are very delicate and light, y... Esophageal Dilators
The dilatation of cicatricial stenosis of the esophagus can be done safely only by endoscopic methods. Blind esophageal bouginage is highly dangerous, for the lumen of the stricture is usually eccentric and the bougie is therefore apt to perforate ... Esophagoscopes
The esophagoscope, like the bronchoscope, is a hollow brass tube with beveled distal end containing a small electric light. It differs from the bronchoscope in that it has no perforations, and has a drainage canal on its upper surface, or next to ... Forceps
Delicacy of touch and manipulation are an absolute necessity if the endoscopist is to avoid mortality; therefore, heavily built and spring-opposed forceps are dangerous as well as useless. For foreign-body work in the larynx, and for the removal of ... Gastroscopes
The gastroscope is of the same construction as the esophagoscope, with the exception that it is made longer, in order to reach all parts of the stomach. In ordinary cases, the regular esophagoscopes for adults and children respectively will afford a... Hooks
No hook greater than a right angle should be used through endoscopic tubes; for should it become caught in some of the smaller bronchi its extraction might result in serious trauma. The half curved hook shown in Fig. 38 is the safest type; better st... Laryngoscopes
The regular type of laryngoscope shown in Fig. I (A, B, C) is made in adult's, child's, and infant's sizes. The instruments have a removable slide on the top of the tubular portion of the speculum to allow the removal of the laryngoscope after the ... List Of Instruments
The following list has been compiled as a convenient basis for equipment, to which such special instruments as may be needed for special cases can be added from time to time. The instruments listed are of the author's design. 1 adult's laryngosco... Measuring Rule
It is customary to locate esophageal lesions by denoting their distance from the incisor teeth. This is readily done by measuring the distance from the proximal end of the esophagoscope to the upper incisor teeth, or in their absence, to the upper ... Mechanical Spoon
When soft, friable substances, such as a bolus of meat, become impacted in the upper esophagus, the short mechanical spoon (Fig. 30) used through the esophageal speculum is of great aid in their removal. The blade in this instrument, as the name sug... Mouth-gag
Wide gagging prevents proper exposure of the larynx by forcing the mandible down on the hyoid bone. The mouth should be gently opened and a bite block (Fig. 16) inserted between the teeth on the left side of the patient's mouth, to prevent closing o... Nstrumentarium
Direct laryngoscopy, bronchoscopy, esophagoscopy and gastroscopy are procedures in which the lower air and food passages are inspected and treated by the aid of electrically lighted tubes which serve as specula to manipulate obstructing tissues out ... Operating Room
All endoscopic procedures should be performed in a somewhat darkened operating room where all the desired materials are at hand. An endoscopic team consists of three persons: the operator, the assistant who holds the head, and the instrument assista... Oxygen Tank And Tracheotomy Instruments
Respiratory arrest may occur from shifting of a foreign body, pressure of the esophagoscope, tumor, or diverticulum full of food. Rare as these contingencies are, it is essential that means for resuscitation be at hand. No endoscopic procedure shoul... Papilloma Forceps
Papillomata do not infiltrate; but superficial repullulations in many cases require repeated removals. If the basal tissues are traumatized, an impaired or ruined voice will result. The author designed these forceps (Fig. 29) to scalp off the growth... Pleuroscopes
As mentioned above the anterior commissure laryngoscope and the esophageal specula make very efficient pleuroscopes; but three different forms of pleuroscopes have been devised by the author for pleuroscopy. The retrograde esophagoscope serves very... Rotation Forceps
It is sometimes desired to make traction on an irregularly shaped foreign body, and yet to allow the object to turn into the line of least resistance while traction is being made. This can be accomplished by the use of the rotation forceps (Fig. 20)... Safety-pin Closer
There are a number of methods for the endoscopic removal of open safety-pins when the point is up, one of which is by closing the pin with the instrument shown in Fig. 37 in the following manner. The oval ring is passed through the endoscope until i... Spectacles
If the operator has no refractive error he will need two pairs of plane protective spectacles with very large eyes. If ametropic, corrective lenses are necessary, and duplicate spectacles must be in charge of a nurse. For presbyopia two pairs of spe... Sponge-pumping
While the usually thin, watery esophageal and gastric secretions, if free from food, are readily aspirated through a drainage canal, the secretions of the bronchi are often thick and mucilaginous and aspirated with difficulty. Further-more, bronchia... Tissue Forceps
With the forceps illustrated in Fig. 28 specimens of tissue may be removed for biopsy from the lower air and food passages with ease and certainty. They have a cross in the outer blade which holds the specimen removed. The action is very delicate, t... Tucker Forceps
Gabriel Tucker modified the regular side-curved forceps by adding a lip (Fig. 21) to the left hand side of both upper and lower jaws. This prevents the shaft of a tack, nail, or pin, from springing out of the grasp of the jaws, and is so efficient t... Upper-lobe-bronchus Forceps
Foreign bodies rarely lodge in an upper-lobe bronchus, yet with such a problem it is necessary to have forceps that will reach around a corner. The upper-lobe-bronchus forceps shown in Fig. 27 have curved jaws so made as to straighten out while pas...