Residency Training in General Surgery

ENDOSCOPY (PGY-2): Goals and Objectives

Goals

To acquire skills and knowledge to perform rigid sigmoidoscopy, flexible sigmoidoscopy, esophagogastroduodenoscopy and colonoscopy; to perform some therapeutic procedures and be familiar with percutaneous endoscopy gastrostomy.

Objectives

l To understand equipment necessary and available for endoscopy, different scopes and their functioning; cleaning and disinfecting the scopes and accessory equipment like biopsy forceps snares, brushes, etc.
l To learn the indications and contraindications for the procedures.
l To acquire skills for patient preparation including mechanical bowel preparations, medications to be stopped and lab tests, etc.
l To gain knowledge of conscious sedation; medications used; dosages; frequency of administration, side effects and antidotes.
l To acquire skills for patient monitoring: BP, pulse oximetry, HR, EKG and antibiotic prophylaxis when indicated.
l To gain knowledge of the complications of the procedures, their diagnosis and management.
l To gain knowledge of anatomic landmarks of upper gastrointestinal tract and colon; upper endoscopy; esophagus and its upper and lower sphincters; stomach; cardia, fundus, body antrum, pylorus; duodenum; bulb, second and third parts and ampulla; lower endoscopy; rectum, sigmoid splenic flexure; transverse colon, hepatic flexure, ascending colon and cecum.
l To learn the variations in anatomy: spasm, redundancy, angulation, fixation, prominent folds, etc.
l To gain knowledge of the disease processes and pathologic conditions encountered; ulcers, gastritis, hiatus hernia, esophagitis, polyps (different types) cancer diverticula, inflammation in the colon, etc.
l To acquire skills concerning advancement of the scope through the colon and upper gastrointestinal tract; technical aspects, patient positioning, external compression, maneuvers to avoid or remove loops during colonoscopy.
l To perform some therapeutic procedures: polypectomies, biopsy dilatation; percutaneous endoscopy gastrostomy, indications for the procedure, candidates, techniques and complications.