(About Endoscopic Instruments)
Instrument usage: Endoscopic instruments are inserted into a body orifice.1 Endoscopes used for viewing are hollow instruments with a rigid hollow sheath made of brass, stainless steel, or plastic, such as bronchoscopes, esophagoscopes, or sigmoidoscopes. Endoscopes can also have a fiberoptic cable inside to provide light or can be used for manual insufflation of air for visibility.1 Endoscopes can also be lensed and be either rigid or flexible with eyepiece lens to view in several directions, and can have the ability to connect to a light source for illumination and a working channel to pass instrumentation.1 Endoscopic instruments include instrumentation, which may be disposable or reusable, including forceps, graspers, and scissors.2
Key differences:
Rigid endoscopes, such as sinuscopes, with cords come in multiple sizes that can attach to a camera in to take photos and videos and allow the surgical team to view the procedure.1
There are a variety of forceps, graspers, and scissors with different types of tips and sizes and some that can remove tissue, cauterize, and control bleeding.2 The tips can vary, but they all have a ringed handle that can be locking or nonlocking.1 The surface of the jaws can be smooth, serrated, or toothed, and the jaws can rotate or be fixed.1
Flexible endoscopes, such as colonoscopes, have a cord that is attached for light and is attached to a camera in order to take photos and videos and allow the surgical team to view the procedure. The working channel can accommodate flexible forceps, graspers, and cautery.
Safety on the sterile field:
Scopes should be examined before use to be certain that the visibility is appropriate and that the light cord fits correctly.
It is important to wipe the tips of the forceps, graspers, and scissors between uses with a wet sponge to remove any debris. Most often, the debris that is removed should be saved for pathology, depending upon the facility’s policy.
A cold scope entering a cavity can cause fogging.1 A scope warmer and anti-fog solution should be used on the sterile field.
Scrub personnel must look at the sheath of the forceps, graspers, and scissors to be certain that the instrument is in working order.
Flexible endoscopes must be precleaned at the point of use before processing at the end of the procedure.3
Instrument names:
Instruments are called by their use, such as “scope” or “grasper.” If there are multiple sizes or angles, the surgeon will preface the size or type of tip before the name, such as “45 degree scope” or “upward grasper.”
References:
1. Phillips, Nancymarie. Berry & Kohn's operating room technique. Elsevier Health Sciences, 2016.
2. Rothrock, Jane C. Alexander's Care of the Patient in Surgery-E-Book. Elsevier Health Sciences, 2018.
3. Guidelines for Perioperative Practice. Flexible endoscopes. AORN, Inc, Denver, CO; 2021.