List of Video Clips viii Preface to the Eighth Edition x Preface to the First Edition xi Acknowledgments xii About the Companion Website xiii 1 Welcome to Endoscopy 1 Resources and links 4 2 The Endoscopy Unit Staff and Management 6 Endoscopy units 6 Staff 9 Management behavior and teamwork 10 Documentation and quality improvement 10 Educational resources 11 Further reading 11 3 Endoscopic Equipment 13 Endoscopes 13 Endoscopic accessories 18 Ancillary equipment 19 Electrosurgical units 20 Lasers and argon plasma coagulation 20 Equipment maintenance 21 Infection control 22 Cleaning and disinfection 22 Further reading 26 4 Patient Care Risks and Safety 27 Patient assessment 27 Patient education and consent 32 Physical preparation 37 Sedation/anesthesia 37 Recovery and discharge 40 Managing adverse events 40 Further reading 41 5 Upper Endoscopy: The Fundamentals 43 Patient position 43 Endoscopist position 44 Endoscope Handling 44 Passing the endoscope 45 Routine diagnostic survey 48 Stomach 50 Problems during endoscopy 56 Recognition of lesions 57 Specimen collection 62 Diagnostic endoscopy under special circumstances 65 Further reading 67 6 Therapeutic Upper Endoscopy 69 Benign esophageal strictures 69 Achalasia 73 Esophageal cancer palliation 74 Gastric and duodenal stenoses 77 Gastric and duodenal polyps and tumors 78 Foreign bodies 78 Acute bleeding 82 Enteral nutrition 90 Further reading 94 7 Colonoscopy and Flexible Sigmoidoscopy 97 History 97 Indications and limitations and alternatives 97 Informed consent 101 Contraindications and infective hazards 102 Patient preparation 103 Medication 110 Equipment--present and future 114 Anatomy 119 Insertion 125 Handling "single-handed" "two-handed" or two-person? 127 Sigmoid colon--accurate steering 131 Endoscopic anatomy of the sigmoid and descending colon 134 Sigmoid colon--the bends 137 Sigmoid colon--the loops 137 Diverticular disease 145 Descending colon 147 Splenic flexure 148 Transverse colon 152 Hepatic flexure 156 Ascending colon and ileo-cecal region 158 Overtubes and balloon colonoscopy 165 Examination of the colon 165 Stomas 174 Pediatric ileocolonoscopy 174 Per-operative colonoscopy 175 Further reading 176 8 Therapeutic Colonoscopy 179 Equipment 179 Principles of polyp electrosurgery 182 Approach to polypectomy 185 Selection of polypectomy technique 187 Polypectomy: Diminutive and small polyps 187 Polypectomy: Large polyps 191 Polypectomy: Problem polyps 198 Recovery of polypectomy specimens 200 Risks of polypectomy 202 Other therapeutic procedures 205 Further reading 208 9 Advanced Endoscopic Procedures 211 Small bowel endoscopy 211 Endoscopic retrograde cholangiopancreatography (ERCP) 212 Endoscopic ultrasound (EUS) 212 Bariatric endoscopy 212 Anti-reflux procedures 213 Third space procedures and NOTES 213 Epilogue: The Future? Comments from the Senior Authors 214 Index 216.