Ideas That Work: Avoid the Endoscope Tipping Point

Practical pearls from your colleagues

Even when endoscopy staff are well-taught and well-trained, accidents happen in what can be fast-paced, high-volume environments at GI centers. One area where those accidents can happen regards the delicate distal tip of an endoscope, where the camera and other electronics reside.

Eric M. Pauli, MD, FACS, FASGE, David L. Nahrwold Professor of Surgery, chief of the Division of Minimally Invasive and Bariatric Surgery and director of endoscopic surgery at Penn State Milton S. Hershey (Pa.) Medical Center, says these tips can be damaged depending on how the scope is hung before a procedure.

“Our scope tower has a little device to hang the scope so it hangs straight and doesn’t touch the floor,” he says. “The team will often have the scope hanging but sit the scope tip on a little side table, so it’s not hanging straight down. Then somebody moves the table or the scope tower, and the tip drags off the end of the table, starts swinging like a pendulum and then hits the wall, the patient’s bed or the endoscopy tower. If it isn’t raised up high enough, it hits the floor.”

When Dr. Pauli walks into the OR and sees this scenario, he immediately speaks up. “The first thing I do is say, ‘Hey, let me explain to you that while this looks safe to you because the scope tip is not dangling in the air, having it on the table is probably more dangerous,’” he says. “We talk about it, and then I put the scope in a very neutral position, and we leave it there.”

Dr. Pauli also encourages the use of inexpensive endoscope tip protectors to ensure that if the tip does accidentally bang into something, any potential damage can be mitigated. OSM