The document describes an esophagoscope, which is a metal tube with a long handle and shaft used for diagnostic and therapeutic procedures in the esophagus. It lists indications such as evaluating tumors, bleeding, esophagitis, and chest pain, as well as removing foreign bodies and dilating strictures. Contraindications include hemodynamic instability, perforation, and anticoagulation. The technique involves examination, consent, left lateral positioning, moderate sedation, and advancing the scope through the oropharynx and esophageal lumen while insufflating air. Potential complications are bleeding, infection, perforation, aspiration, over sedation, and hypoventilation.

1. Esophagoscope.
Dr. O’ Shea’s Tutorial.
Valmiki Seecheran.
Surgery Senior Clerkship.
UWI Cave Hill | Class of 2015.

2. Esphagoscope.

3. Description.
• Metal tube.
• Long Handle.
• Long shaft with no distal fenestrations.
• 2 proximal ports for suction and visualization.

4. Indications.
• Diagnostic.
• Tumor in prox 1/3 & mid 1/3 esophagus.
• Cause of GI bleeding?
• Esophagitis.
• GERD.
• Hiatal hernia.
• Chest pain.
• Therapeutic.
• Foreign body removal.
• Stricture dilatation.
• Sclerotherapy.

5. Contraindications.
• Absolute.
• Hemodynamic instability.
• Failure to obtain consent.
• Perforation present.
• Relative.
• Anticoagulopathies.
• Head & neck surgery.
• History of previous intolerance to procedure.

6. Technique.
• Full history & examination.
• Focus on oral cavity and pharynx, thyroid gland, cervical and
supraclavicular lymph nodes.
• Gain consent.
• Position patient in left lateral decubitus position.
• Moderate sedation – narcotic + benzodiazepine.
• Scope is inserted into the oropharynx with visualization of epiglottis and
vocal cords.
• The scope is advanced through piriformis sinuses and esophageal lumen.
• Air insufflation is used to distend esophageal lumen.

7. Complications.
• Bleeding.
• Infection.
• Perforation.
• Aspiration.
• Over sedation.
• Hypoventilation.
• Cervical sepsis.
• Dental injury.

8. Thank you.