Page 541 - Clinical Small Animal Internal Medicine

49 Gastrointestinal Endoscopy 509

(a) (b)
VetBooks.ir

Figure 49.2 Control cluster of a typical flexible videoendoscope, in this case a gastroduodenoscope. (a) The control wheels, labeled U^
D^ and L^ R^, control tip deflection up/down and left/right, respectively. The direction of tip deflection is in reference to the center line
and upper surface of the control cluster. Outside the U‐D wheel, and in the center of the L‐R wheel are a lever and wheel, respectively,
marked F>; these are tension controls (labeling indicates the direction to give greater freedom of movement) that can be used to reduce
tip deviation freedom. (b) A selection of buttons on this particular endoscope pause video capture and trigger still image capture; these
are not present in this position in all endoscopes of this type. Below the two image capture buttons, a press button with a red outer rim
operates suction. The bottom button, with a blue rim and small hole in the center, is a combined air/water insufflation control. Placing the
operator’s finger over the central hole without depressing the button will cause air insufflation, while pressing down the button causes
water to be delivered from the end of the scope, washing across the distal lens. While other endoscopes from other manufacturers may
have different colored or shaped buttons, the positioning of vacuum above air/water insufflation is standard across all manufacturers.
Below the control buttons, a black rubber cuff is apparent; this is the seal for the working channel.

commercially available printers, thus these printers and these systems can require significant configuration and
their disposables (ink ribbons, specific papers) are software support, which should be clarified during the
expensive and increasingly difficult to source. These purchasing process.
printer systems are hard to recommend for integration A final option that is commonly used with refurbished
into modern veterinary practice workflows. but older endoscopy systems is to attach some form of
At the opposite extreme from the traditional dye subli- recording device (commonly a CD or DVD recorder) to a
mation printer, some modern endoscopy systems are video output from the endoscope processor. In some
able to record digital video or digital still image captures cases, it is possible to configure these systems to trigger
from the endoscope in real time, and then export the capture using either a foot pedal or the capture button on
resulting files to either a hospital‐wide DICOM system the endoscope, but again as technology progresses and
or directly into a hospital electronic record system. changes, this is becoming increasingly difficult. The sim-
These capabilities are very useful for streamlining record plest, but most risky, option is to simply collect and
management in busy practices, and also provide the abil- record all video from the video output and record it as a
ity to show captures to clients and generate multiple cop- continuous stream. If doing this, it is important to con-
ies that can be saved to removable media or transferred sider the length and size of the recording, as many upper
digitally via email. The specific hospital management and lower gastrointestinal tract endoscopy procedures
systems and DICOM products that endoscopy systems will last for 1.5 hours or more. Use of CD/DVD recorder
can interface with vary by manufacturer, and should be systems also requires the endoscope operator or assist-
considered if a practice is planning to purchase a newer ing technical staff to remember to start and stop record-
system. Aftermarket image capture and DICOM export ing, and finalize the recording to allow burning the final
hardware are also available from some vendors, again disk. The disks themselves have variable, and often short,