Preparation

Connect a 20-ml syringe to the endoscope tube connector and flush the air route several times with air to remove any water that might cause a blockage (Fig. 7.1).

Attach a backflow check valve made of rubber (ST-03B) to the proximal end of the overtube. Adjust the length of the rubber protruding proximally to ensure that the rubber does not become entangled between the overtube and the endoscope, thereby gener ating resistance. Secure the rubber with surgical tape (Fig. 7.2).

Connect a 20-ml syringe to the endoscope tube connector and flush the air route several times with air to remove any water that might cause a blockage (Fig. 7.1).

3. Connect the balloon pump con troller to the overtube and the endoscope with dedicated tubes (Fig. 7.3).

4. Turn on the power of the balloon pump controller. Press and light up the scope selector switch (2) on the remote switch box (Fig. 7.4a). Immerse the endoscope tip in a glass of water to confirm that air bubbles come out the tip (Fig. 7.4b). After confirmation, take the endoscope tip out of the water, wipe the water off the tip, and then press the scope's pause switch (4) on the remote switch box.

3. Connect the balloon pump con troller to the overtube and the endoscope with dedicated tubes (Fig. 7.3).

5. Press and light up the overtube selector switch (1) on the remote switch box (Fig. 7.4a) to inflate the overtube balloon. Immerse the overtube balloon in a glass of water to check it for air leaks (Fig. 7.5). After confirmation, press the overtube selector switch (1) again to turn its light off and deflate the balloon.

6. To lubricate the endoscope, pour 10-20 ml of water into the overtube; then hold and move the overtube to run the water through it (Fig. 7.6).

7. Press and turn off the light of the scope pause switch (4) (Fig. 7.4a) and pass the endoscope through the overtube while air is coming out of the endoscope tip (Fig. 7.7). After the passage, slide the overtube close to the endoscope handle, wipe water off the endo scope tip, and press the scope pause switch (4).

8. Use an alcohol swab to wet the device used to attach a balloon to the tip (jig) and mount an endo scope balloon (Fig. 7.8).

6. To lubricate the endoscope, pour 10-20 ml of water into the overtube; then hold and move the overtube to run the water through it (Fig. 7.6).

8. Use an alcohol swab to wet the device used to attach a balloon to the tip (jig) and mount an endo scope balloon (Fig. 7.8).

Fig. 7.8. Mount the endoscope balloon on a jig

9. Use an alcohol swab to wet the endoscope tip and attach the endoscope balloon mounted on the device (jig) onto the endoscope tip (Fig. 7.9).

Fig. 7.9. Attach the endoscope balloon to the endoscope tip

10. Mount a fixing rubber on a mounting tool (Fig. 7.10a). Use the mounting tool to secure the endoscope balloon with the fixing rubber at a site close to the handle (Fig. 7.10b).

Fig. 7.10a. Mount a fixing rubber on a mounting tool

Fig. 7.10b. Secure the endoscope balloon with the fixing rubber at a site close to the handle

11. Attach a hood to the distal end of the endoscope balloon (Fig. 7.11). Watch the endoscopic monitor to ensure that the hood does not interfere with the field of view.

12. Cut surgical tape into a strip (width 7 mm, length 30 mm) and wind the strip around the bound ary between the hood and the endoscope balloon (Fig. 7.12a). Use the mounting tool to mount the fixing rubber so the fixing rubber and the surgical tape wound on the endoscope balloon overlap (Fig. 7.12b).

13. Press and turn off the light of the scope pause switch (4) (Fig. 7.4a) and immerse the endoscope tip in a glass of water to examine the inflated endoscope balloon for air leaks (Fig. 7.13). Then, press and turn off the light of the scope selector switch (2) to deflate the endoscope balloon.

14. Finally, apply antifog lens cleaner to the objective lens at the endo scope tip.

11. Attach a hood to the distal end of the endoscope balloon (Fig. 7.11). Watch the endoscopic monitor to ensure that the hood does not interfere with the field of view.

Fig. 7.13. Check the endoscope balloon for air leaks
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