Greetings,
To welcome all incoming first year GI fellows, I'm making a simple tutorial on how to set up an endoscopy cart in case you are called in without tech support. Good endoscopists must have a good understanding of how to set up and troubleshoot equipment if need be.
To welcome all incoming first year GI fellows, I'm making a simple tutorial on how to set up an endoscopy cart in case you are called in without tech support. Good endoscopists must have a good understanding of how to set up and troubleshoot equipment if need be.
Speaking from a personal perspective, a major portion of my anxiety on starting call was my inability to set up a cart on my own or troubleshoot problems that could arise. I was fortunate to have seniors who went out of their way to help me out with this early in fellowship.
This may seem like a daunting task, But fret not. Do it enough times and it becomes intuitive. By no means is this an exhaustive 'how to' but more of a quick reference. Most carts have the following (1) monitor (2) supply cabinet and (3) scope tower
These three parts in tow can be quite heavy but can be transported around with motorized assistance making things a little easier. Navigating and steering needs some practice so start at the slower settings and be careful not to run anyone over!
Once you've arrived at your destination the cart can be disengaged by pushing 2 seperate black round levers for easy break down into the 3 aforementioned components. (Tower*supply cabinet *monitor). Sadly, the supply cabinet is not invited to the party and stays outside the room.
This sorry attempt at cable management may invoke sudden panic in anyone with even the slightest semblance of OCD. Fortunately for us, we can simply focus on what we need. 2 plugs for power and 1 for data.
For the power source ⚡: Connect the plugs for the tower and monitor into appropriate sockets. Positioning is important here as the monitor and tower will be on opposite sides in relation to the patients bed.
As for the data 📶: connect the ethernet cable (optional)
As for the data 📶: connect the ethernet cable (optional)
There is a video 🎥 output cable found in the back of the tower that you must attach to the back of the monitor. This will allow a video feed to be shown on the big screen. Don't forget to turn on the monitor!
Now we bring our attention to the tower. This is command central. The mothership. Here you will be able to control the elements like water 💦 (h2o pedal and wipers), air 💨 (insufflation and suction), fire 🔥 (cautery) and earth 💩 (ermm.. stool?)
Looking more closely from top to bottom with extreme simplification here you will see (1) video processor (2) light source/center console (3) air supply pump (4) water/suction pump. (Almost forgot - the PC 💻 in the middle row)
There are five switches there. You guessed it. You are going to turn all of them ON in quick succession for added effect. 🔛
Now comes the scope. It goes without saying you need the right scope for the right job. Insert the light guide connector into the light source receiver. You should hear a satisfying click. A very satisfying click.
Connect the air/water wiper connector. You'll notice there are two concentric circles one larger than the other. Squeeze it right in there.
For the water source, there's a special connector that needs to be attached to the water valve. This will be found in the supply cabinet. The water tubing then attaches to the connector.. Right next to it is the suction channel, attach the suction tubing (not pictured)
At this stage the scope insertion area should look like this. At 🕘 is the air/wiper connector tubing . At 🕒 you'll have a separate suction and water tubing. All connected and ready to go
From the supply cabinet you will find conveniently packaged buttons designed for the control body of the scope including (1) air/water valve (2) suction valve (3) biopsy channel cap
Place to valves and the biopsy channel cap has pictured below.
Don't forget to bring out the pedals. The white pedal is your water pump. Whether navigating through unprepped bowel or aggressively dislodging clots - placement is key as you don't want to keep looking down to find the pedal during the procedure
Log into your endoscopy software 🖥️
Turn ON the air 💨 and light 💡 source on the center console 🔛
Now things are starting to take shape here
Check the monitor to make sure you've have intact fiber optics with buttery smooth live video feed. You can also take a moment to make sure your hair is all right and looking good.
This step is most often forgotten. The white balance. Point the camera tip of the scope on a white surface and hold the white balance button on the video processing console until a prompt on the screen states that the process is complete.
Check all functions including air, suction, water, video feed, light source. Make sure everything is working before you start your procedure. Happy scoping!
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