Periprocedural Care
Patient Education and Consent
Informed consent must be obtained prior to the procedure. The risks, benefits, complications, and alternative treatments must be reviewed with the patient.
Next:
Preprocedural Planning
Before the procedure, a full history should be obtained from the patient, and all previous and current medical records should be reviewed. A full physical examination should be performed, with special attention given to the oral cavity and pharynx. The thyroid and parathyroid glands should be palpated, and palpation for cervical and supraclavicular lymph nodes should be performed when esophageal cancer is suspected. The existence of poor dentition should be documented.
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Next:
Patient Preparation
The patient is placed in the left lateral decubitus position. Moderate sedation is then accomplished by using a combination of narcotic and benzodiazepine, which are infused intravenously in incremental doses.
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Media Gallery
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Esophagoscopy on a 3-year-old child. The esophagoscope is introduced via the mouth. As the scope enters the esophageal inlet, you can see the larynx with an endotracheal tube passing through the vocal folds. The esophagocscope meets some resistance as it passes through the upper esophageal sphincter. The esophagus is then entered, and the mucosal lining of the esophagus is evaluated. The esophagus is then passed through the lower esophageal sphincter, entering the stomach. The rugae of the stomach are very distinct. The pylorus is visualized first, and then the scope is turned 180º, and the lower esophageal sphincter is visualized. You can see the scope coming through the lower esophageal sphincter. Video courtesy of Ravindhra G Elluru, MD, PhD.
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This video, captured via esophagoscopy, shows balloon dilation of the distal esophagus. This is performed in patients with dysphagia who are found to have an esophageal stricture or ring. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video, captured via esophagoscopy, shows band ligation of esophageal varices. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video shows a normal esophagogastric junction (EGJ). This is where the esophageal squamous mucosa meets the gastric columnar mucosa. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video, captured via esophagoscopy, shows biopsies being obtained from the esophagus. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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Esophagoscopy: This video shows inflammation of the esophagus that appears infectious in origin. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video, captured via esophagoscopy, shows "trachealization" of this esophagus. This is a condition in which rings in the esophagus resemble the rings of the trachea. This is commonly seen in patients with eosinophilic esophagitis. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video, captured via esophagoscopy, shows the use of a HALO 360 device to perform radiofrequency ablation for Barrett esophagus. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video shows esophagoscopy with normal findings. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video shows esophagoscopy with normal findings. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video shows esophagoscopy with normal findings. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video shows a stent that has successfully been deployed into the esophageal lumen. This patient had a small esophageal perforation, and the stent was placed to allow him to heal and eat. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video, captured via esophagoscopy, shows band ligation of esophageal varices. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video, captured via esophagoscopy, shows band ligation of esophageal varices. One of the varices has a red wale sign, which is a sign of recent bleeding. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video shows circumferential Barrett esophagus via esophagoscopy. The HALO 360 device is in the esophageal lumen ready to perform radiofrequency ablation. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video, captured via esophagoscopy, shows the Barrett esophagus after having just undergone a treatment with radiofrequency ablation using the HALO 360. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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This video, captured via esophagoscopy, shows a long circumferential segment of Barrett esophagus. Video courtesy of Dawn Sears, MD, and Dan C Cohen, MD, Division of Gastroenterology, Scott & White Healthcare.
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