How to access a difficult ileo-cecal valve with a biopsy forceps
KWT Medicals News • May 12, 2019
Abiopsy forceps is gently advanced(just the tip) The valve is positioned at 5-6 o’clock. Then the forceps is positioned in the entrance of the valve by sliding it from left to right.
The next step is to turn the wheel of the endoscope downwards. In this way pressure is applied at the valve and the ileum is aligned with the endoscope.
The endoscope is further advanced and the forceps is retrieved if not used anymore.
Other trick that maybe used:
- Underwater access(use of water jet)
- Change of patient’s position
- External pressure
- Obtain as straight endoscope without loops
- Use of a cap
The technique of the biopsy forceps should be applied only by experienced endoscopists due to the risk of perforation! This risk is higher in case of ileitis. Gentle moves and clear view are crucial to avoid complications.