The book is well illustrated throughout with color line drawings and diagrams. It is an indispensable resource for all trainees in gastroenterology and essential read for all practising endoscopists who are interested in improving their techniques.
The book is well illustrated throughout with color line drawings and diagrams. It is an indispensable resource for all trainees in gastroenterology and essential read for all practising endoscopists who are interested in improving their techniques.
Christopher Williams is Consultant Physician in Gastrointestinal Endoscopy at St. Mark's and Northwick Park Hospitals in London, England. He is Director (with Brian Saunders) of the Wolfson Unit for Endoscopy and its associated Kennedy Leigh Academic Centre. This focuses on development of new approaches to colonoscopy, its teaching, and aspects of colorectal cancer prevention. He has private practice at the London Clinic and is Honorary Consultant at several other hospitals.
The son of two physicians, Christopher Williams was born in 1938 in Norwich, England. From 1940 to 1944 he stayed with a medical family in Boston, Massachusetts, USA, as a war evacuee. His pre-clinical education and physiology degree was at Oxford University. He qualified from University College Hospital, London where he did internships, with medical residencies, there and at other leading London Hospitals.
In 1970 Dr Williams moved to St Mark's Hospital as Senior Resident, to work with the distinguished gastroenterologist Professor John Lennard-Jones. Following a Research Fellowship at St Mark's, the post of Consultant Physician in GI Endoscopy was created in 1975, between St Mark's and St Bartholomew's Hospitals. He conducted pediatric colonoscopy at St Bartholomew's, the Hospital for Sick Children, and the Royal Free Hospital.
Since 1970 Christopher Williams has had experience of most forms of GI endoscopy, especially colonoscopy and polypectomy (around 35,000 procedures), a field in which he has taught, published, demonstrated, and lectured widely. He has written numerous articles on colonoscopy, colonic neoplasia, and related topics, and is co-author (with Peter Cotton) or editor of five books relating to the colon and endoscopy. He gave the endoscopy Foundation Lectures of the British Society of Gastroenterology in 1976 and 1996, and was Endoscopy Vice-President of the Society in 1987.
In 1999 Dr Williams was elected Fellow of the Royal College of Surgeons in recognition of his work on colonoscopy. His particular interests include teaching and television teaching of colonoscopy, and the application of new approaches and technology to facilitate the technique. This has included development of the hot-biopsy forceps, variable-stiffness colonoscope, 3-D-imager technology, and computer simulation.
Robert 'Rob' Hawes is Professor of Medicine at the Medical University of South Carolina in Charleston, USA, and is an adjunct Professor of Bioengineering at Clemson University.
He was born in 1954 in Berkley, California, and some attribute his 'radical' nature to his place of birth. His father was professor of theatre and drama at Indiana University in Bloomington, Indiana, where he learned to love the game of basketball, hung out in the quarries made famous by the movie Breaking Away and, under the tutelage of his father, learned to project his voice to the far reaches of the universe.
His undergraduate education and medical training were completed at Indiana University. He went on to obtain his internal medicine training at Indiana University followed by a gastroenterology fellowship at the same institution. He joined the faculty at Indiana University in 1985 and was extremely fortunate to receive an immediate sabbatical to spend a year training with Peter Cotton at The Middlesex Hospital in London, UK, where he refined his skills in ERCP and laser therapies. He remained on faculty at Indiana University from 1985 until 1994, during which time he was promoted from assistant to associate and ultimately to full professor. In 1994, he joined Peter Cotton to help establish a comprehensive Digestive Disease Center at the Medical University of South Carolina.
Rob Hawes' fundamental interest is diagnostic and therapeutic endoscopy. Three areas of special interest include pancreaticobiliary endoscopy, endoscopic ultrasound and experimental endoscopic procedures.
Dr Hawes has served on the Governing Board of the American Society of Gastrointestinal Endoscopy and is vice-chairman of the Investigation Review Board at the Medical University of South Carolina.
Dr Brian Saunders is Senior Lecturer and Honorary Consultant Physician at St Mark's and Northwick Park Hospitals, and is head of the hospital's newly formed Academic Department of Endoscopy. His main research interests include therapeutic colonoscopy, endoscopy teaching, and the development and evaluation of novel endoscopic technology.
Brian Saunders qualified in medicine from University College Hospital, London in 1988. He trained in General Medicine in the North East of England and in Gastroenterology in London at St Mark's, Guy's, and Lewisham Hospitals. In 1996 he completed his MD thesis on Advances in Colonoscopic Practice and was also awarded the Hopkin's Endoscopy Prize from the British Society of Gastroenterology.
Acknowledgments, ix
1 The Endoscopy Unit and Staff, 1
Staff, 1
Facilities, 1
Management and behavior, 3
Documentation, 4
Educational resources, 5
2 Endoscopic Equipment, 7
Endoscopes, 7
Endoscopic accessories, 11
Ancillary equipment, 12
Electrosurgical units, 12
Lasers and argon plasma coagulation, 13
Equipment maintenance, 14
Infection control, 15
Cleaning and disinfection, 16
3 Patient Care, Risks, and Safety, 22
Patient assessment, 22
Patient education and consent, 26
Physical preparation, 31
Monitoring, 31
Medications and sedation practice, 32
Recovery and discharge, 34
Managing an adverse event, 35
4 Upper Endoscopy: Diagnostic Techniques, 37
Patient position, 37
Endoscope handling, 38
Passing the endoscope, 39
Routine diagnostic survey, 42
Problems during endoscopy, 49
Recognition of lesions, 50
Specimen collection, 55
Diagnostic endoscopy under special circumstances, 58
5 Therapeutic Upper Endoscopy, 61
Benign esophageal strictures, 61
Achalasia, 65
Esophageal cancer palliation, 66
Gastric and duodenal stenoses, 70
Gastric and duodenal polyps and tumors, 70
Foreign bodies, 70
Acute bleeding, 74
Enteral nutrition, 80
6 Colonoscopy and Flexible Sigmoidoscopy, 87
History, 87
Indications and limitations, 88
Informed consent, 93
Contraindications and infective hazards, 94
Patient preparation, 95
Medication, 105
Equipment—present and future, 111
Anatomy, 116
Insertion, 120
Handling—"single-handed," "two-handed," or twoperson?, 123
Sigmoidoscopy—accurate steering, 128
Endoscopic anatomy of the sigmoid and descending colon, 131
Sigmoidoscopy—the bends, 133
Sigmoidoscopy—the loops, 134
Diverticular disease, 143
Descending colon, 144
Splenic flexure, 145
Transverse colon, 152
Hepatic flexure, 155
Ascending colon and ileo-cecal region, 158
Examination of the colon, 164
Stomas, 172
Pediatric colonoscopy, 172
Per-operative colonoscopy, 173
7 Therapeutic Colonoscopy, 176
Equipment, 176
Polypectomy, 182
Other therapeutic procedures, 202
8 Resources and Links, 208
Web sites, 208
Endoscopy books, 208
Journals with major endoscopy/clinical focus, 209
Index, 211
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