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غرفة التنظير الداخليEndoscopy suite

Upper GI endoscopy (OGD)

A gastroscope passed through the mouth with the patient lying on the left side: down the oesophagus, through the cardia into the stomach, along the body to the antrum, through the pylorus into the duodenal bulb and round into the second part of the duodenum. Read the depth from the incisors, find each landmark from inside, and retroflex in the stomach to see the cardia and fundus from below.

  • Bronchoscopy
  • Gastroscopy
  • Colonoscopy
  • Cystoscopy
  • Ventriculoscopy

Scope view

Preparing the organ…

Tip 0° up, 0° rightShaft turned 0°

↑ ↓ or scroll: advance and withdraw · drag or W A S D: bend the tip · Q E: turn the scope · Enter: go into the chosen orifice

Picture orientation

The picture is what the gastroscope sees, with the scope's up mark at 12 o'clock. It goes in with its up toward the patient's front, so at the start the anterior wall is at 12 o'clock and the posterior wall — against the spine — at 6. The patient lies on the left side, so fluid pools on the left wall. Bending the tip and turning the shaft move all of this, which is why endoscopists read the lumen, not the screen.

The letters on the rim follow the scope as it turns: A anterior, P posterior, R and L the patient's right and left, S and I superior (toward the head) and inferior. An axis shows only while it lies across the picture; one running along the view fades out.

Map

Seen from the front, the patient's right on your left.

You are in

Labels are off: nothing in the picture is named, the breadcrumb is hidden and the map shows no scope until you find it.

Anatomy: BodyParts3D, © DBCLS, CC BY-SA 2.1 Japan — the lumen, its centreline and its landmarks built for this trainer. The lighting, the mucosa and its patterns are drawn, not photographed. Also drawn rather than measured:

  • The oesophagus is a tube of insufflated calibre (19 mm) swept along the BodyParts3D oesophagus's course, shortened toward the cardia so that its length from the upper sphincter to the Z-line is the 24 cm read at the incisors.
  • The upper oesophageal sphincter, the diaphragmatic hiatus and the pylorus are carved as rings at their usual depths; the pyloric ring's opening (12 mm across) is drawn, not measured.
  • The aortic arch and left main bronchus indentations are placed at the standard depths (25 and 27 cm from the incisors) and on the walls standard endoscopic teaching gives them (left anterolateral, left anterior).
  • The Z-line's serrated outline and every mucosal colour are painted per vertex, not taken from images.
  • The gastric rugae along the greater curvature are procedural folds; the stomach's shape is BodyParts3D's, at its modelled volume (about 570 ml).
  • The duodenum is widened to insufflated calibre and ends a few centimetres past the inferior duodenal flexure; its circular folds are procedural.
  • The major papilla, its hooding fold and longitudinal fold, and the minor papilla are modelled bumps placed where the BodyParts3D bile duct meets the second part of the duodenum.