Do’s and Dont’s with an endoscope

Dos and Dont’s with an endoscope


  • Hold the endoscope in the left hand.
    • Left index finger controls either the suction valve or the air/water button.
    • The Left thumb controls the Big wheel. Individuals with large hands can reach the small wheels.
  • Hold the insertion tube in the right hand
    • The right hand is used to advance and withdraw the insertion tube.
    • The right hand applies rotational torque to the insertion tube.
    • The right hand is used to advance accessories in the accessory channel. Ask your nursing colleague to hold the endoscope in position if necessary.
    • Although it is generally recommended to use torque instead of using the right and left deflection wheel sometimes this is necessary and is done using your right hand.
  • Check your endoscope prior to inserting it in your patient.
    • Check that it is sucking fluid by inserting it in a bowl of sterile water and depressing the suction button (Red).
    • Check that it is blowing air by keeping the tip underwater and depressing partially/ covering the air/water button (Blue).
    • Check that it is flushing water by lifting the tip just above the level of water and fully depressing the air/water button.
    • Check that the lens is clear by pointing it to any written material (usually numbers on an endoscope) and looking at the screen to make sure you can read them.
    • Check that all locks are off including the variable stiffness in a colonoscope.


  • Always handle the insertion tube carefully avoiding tight coiling, or accidental striking of the distal tip against hard surface.
  • Avoid forcing deflection wheels. If they feel tight check that the locks have been unlocked.
  • Never force instruments through the Accessory channel. This inevitably results in damage and prolonged / expensive repairs.
    • If an instrument is unable to pass through ensure that the endoscope is not in a tight loop or the tip has been deflected at a tight angle.
    • Check that the Biopsy forceps are closed and injection needles/ endoclip’s have been withdrawn back into their sheath.
    • Check that the diameter of the port is compatible with instrument being used.

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