In this detailed instructional video titled "How to Perform Safe Upper and Lower GI Endoscopy," we walk you through the essential steps, techniques, and safety protocols involved in performing diagnostic and therapeutic gastrointestinal endoscopy. The focus is on ensuring patient comfort, minimizing complications, and achieving accurate visual and pathological assessments. Whether you're a medical trainee, endoscopy nurse, or practicing gastroenterologist, this guide offers critical insights into delivering endoscopy safely and effectively.

Understanding GI Endoscopy

GI endoscopy is a minimally invasive procedure used to visualize, diagnose, and sometimes treat disorders of the gastrointestinal tract. It is divided into:

Upper GI Endoscopy (EGD): Visualization of the esophagus, stomach, and duodenum

Lower GI Endoscopy (Colonoscopy): Evaluation of the colon and rectum

Each procedure requires specific preparation, technique, and awareness of potential complications to ensure patient safety and procedural success.

Patient Preparation (As Demonstrated in the Video)

Upper GI Endoscopy:

Ensure the patient has fasted for at least 6–8 hours before the procedure.
Obtain informed consent and assess for history of allergies, anticoagulation, or prior sedation complications.
Administer a topical anesthetic or mild sedative as needed for comfort.
Position the patient in the left lateral decubitus position.
Monitor vitals throughout the procedure using pulse oximetry and ECG.

Lower GI Endoscopy:

Instruct the patient to follow a clear liquid diet for 24 hours and administer a bowel prep regimen (e.g., polyethylene glycol) the day prior.

Review medical history, especially any prior abdominal surgeries or bleeding tendencies.
Sedation or conscious anesthesia may be used based on patient profile.
Position the patient in the left lateral position, progressing to supine or right lateral if required.
Endoscopic Techniques for Safety and Precision

For Upper GI Endoscopy:

Insert the endoscope gently through the oropharynx while the patient is calm and breathing normally.
Avoid excessive insufflation and advance the scope under direct vision.
Thoroughly inspect the esophagus, GE junction, stomach, pylorus, and duodenum.
Carefully perform biopsies or therapeutic interventions if indicated.

For Lower GI Endoscopy:

Lubricate and gently introduce the colonoscope via the anus.
Navigate through the rectum, sigmoid, and entire colon under visual control, minimizing looping with torque steering.
Use CO₂ insufflation if available to reduce post-procedure discomfort.
Withdraw the scope slowly for thorough mucosal inspection and polyp detection.

Patient Safety Measures

Maintain sterile technique and use high-level disinfection for all endoscopic instruments.
Continuously monitor oxygen saturation, heart rate, and blood pressure.
Be prepared to manage emergencies such as perforation, bleeding, laryngospasm, or vasovagal episodes.
Post-procedure observation is essential, especially if sedation or biopsy was performed.
Provide detailed post-procedure instructions and follow-up planning.

Conclusion

Safe and effective upper and lower GI endoscopy relies on a combination of technical skill, patient-centered care, and adherence to best practices in preparation and infection control. This video demonstrates not only how to perform these procedures but also how to minimize risk and maximize patient comfort and diagnostic yield.

Watch the full video to see a step-by-step demonstration of real endoscopic procedures, expert commentary, and key safety tips that every endoscopy team should know.
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