1. If there is no adverse reaction, the patient can leave. If you do a biopsy, you can go soft 1 ~ 2d.
2. Thoroughly clean the surface of the mirror body, flush the cavity, and drain the moisture. The distal mirror is coated with wax, and the mirror body is rubbed with oil and stored.Laparoscopic Instruments
ENT/endoscopic surgery/fibrosis, bronchial, esophagoscopy
Fiberoptic laryngoscopy, bronchoscopy, and esophagoscopy are collectively referred to as fibroptic endoscopy, with otolaryngology, bronchoscopy, and esophagoscopy commonly used in otorhinolaryngology.
A complete set of fiber endoscopic equipment includes the following three parts: 1 fiber endoscope (such as fiber laryngoscope, fiberbronchoscope); 2 cold light source; 3 accessories (camera, teaching mirror, camera-monitoring system, biopsy forceps, foreign body Clamp, brush, cleaning brush, suction tube, etc., Fig. 18.104.22.168-0-4).
The structure of the fiber esophagoscope is basically similar to that of a fiber bronchoscope. The length of the mirror is 960mm and the diameter of the lens body is 9mm. It is equipped with suction, air supply, cleaning device and jaw hole, and can be inserted into a biopsy forceps or injection.
Fiber esophagoscopy is suitable for:
1. Obstinate sternal pain or esophageal infarction.
2. Unexplained dysphagia and esophageal obstruction.
3. Take lesions on esophageal tissue or observe the effect.
4. Unexplained vomiting, vomiting, acid reflux and loss of appetite, positive findings by barium meal and gastroscopy.
1. Acute upper respiratory tract infection.
2. There are severe hypertension, cardiopulmonary insufficiency and excessive physical weakness.
3. Aortic aneurysm patients.
4. Esophageal corrosive burns and varicose veins less than 2 weeks after vomiting.
5. Obstructive lesions or esophageal foreign body entrance esophagus, should not use fiberoptic esophagoscopy.
Preoperative 6h fasting, water, subcutaneous injection of atropine 0.5mg 30min before surgery, for some emotional stress, may be appropriate to give sedatives, such as diazepam or phenobarbital, remove the removable denture, suction device to remove nasal secretions .Laparoscopic Surgical Instruments
Anesthesia and posture
Conventional mucosal surface anesthesia, 0.5% to 1% tetracaine or 2% lidocaine spray mouth and throat 3 to 4 times, a total of about 2 ~ 3ml. The patient inhaled anesthetic.
1. The patient was lying in the left side of the patient, the head cushion was high, the legs were bent, the body muscles were relaxed, and the mouth teeth were placed on the mouth.
2. The operator sits on the left side of the patient and holds the manipulator of the mirror with his left hand. The right hand assists in turning the angle button to adapt the distal end to the curvature of the patient's mouth and pharynx. The assistant assists the tooth pad with his left hand, and the right hand sends the distal end of the lens body into the mouth and enters about 15 cm, which is a pear-shaped nest. At this time, he feels a greater resistance, the visual field is unclear, and there is a certain degree of blindness. When the mouth of the waiting tube is opened, the resistance stops and the mirror body slides into the esophagus.
3. Observe Shun therapy After entering the esophagus, the mirror tube is immediately sent to the air. Adjust the angle button to see the degree of the esophagus as the degree, and you must see the esophageal cavity. Send water to flush the esophageal cavity and slowly insert it. You can see the status and movement of the esophagus, and see the aortic arch impression, left bronchial impression, and heart beat. When the lens body enters about 40cm, we can see the petal-like mucous membrane folds in the fontanelle. When the fontanelle is open, you can enter the stomach, and then slowly withdraw, observing while exiting. Inspection should pay attention to the wall activity and hardness, lumen conditions and mucosal folds, pay attention to the depth of the mirror tube. If lesions are found, their orientation and depth from the central incisors should be recorded, and photographic records taken and tissue taken. The observation of the esophagus entrance can usually only be performed when the mirror tube exits. Therefore, the optical fiber esophagoscopy sometimes fails to observe the obstruction of the esophagus at the entrance, and sometimes it is necessary to use a hard tube esophagoscopy.
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