Mission

2008-11-22

Introduction 

History and development 

Till 1992/1993 the endoscopic analysis of the function of the upper esophageal sphincter (UES) was impossible. With ultra-thin flexible fiberscopes we tried to see this region performing auto-experiments. Because of the sensitivity of the upper sphincter the attempt to see was resulting in choking and vomiting. Continuous water swallow was permitting to observe for the first time the function of the UES and to register it. Contemporary with the physiological swallow the way to the esophagus and stomach was open. Surprisingly, together with the swallow a hyposensitivity of the pharynx, during the period of the swallowing act was observed. Only in this way food and water may pass the larynx to the esophagus without problems. Beyond the esophagus no reflex reactions disturb the movements of the endoscope. The way is free to analyse the function in every position and under any condition. The explorations are performed without air-insufflations. Air-insufflation in the esophagus and stomach is used in gastroenterology and endoscopic surgery to judge the surface of the extended mucosa. With this procedure the system is brought to a-border-line situation and the normal function of the system is cancelled. The effect of insufflations can be substituted by the natural function of the esophagus like swallowing water or food or belching. In the stomach the natural gas input from the duodenum and esophagus provide us with a good overview also in cases of a full stomach during digestion.

Ergonomy

Traditional endoscopes with integrated channel for the transnasal approach have a small working channel (1.5 – 2 mm) and a large outer diameter (5 – 7 mm) with the risk of nasal damage. Gastroscopes are provided with larger integrated working channels ( 2 – 3.5 mm), but because of the larger outer diameter (9 – 12 mm) they have the disadvantage of the transoral introduction, which is more disturbing for the patient. For this endoscopic procedure the patient needs sedation. The inner shape of the nose (Picture) allows the passage of 2 instruments one above the other: an endoscope without integrated channel and a disposable tube system with suctioning-rinsing channel and a working channel of more than 2.7 mm. In other words it is possible to guide 2 tubes through the nose without harm, one above the other and each with an outer diameter of 3.7 mm, arranged like a “8”. The special designed connection system between both tubes enables to bend the disposable-endoscope-system from the nose to the pharynx and to guide the tube like a car around the obstacles.

 Print this page | Diese Seite drucken

No Comments

No comments yet.

RSS feed for comments on this post.

Sorry, the comment form is closed at this time.