Esophagogastroduodenoscopy and colonoscopy in children: stages of formation and modern capabilities

When conducting a gastroscopic examination in children, it is necessary to take into account the anatomical and physiological differences of the children's gastrointestinal tract. The fact is that children have poorly developed elastic and muscle tissue, and the mucosal wall is very thin and filled with blood vessels. In this regard, their digestive system organs are slightly vulnerable.

Important attention should be paid to the correct choice of device, taking into account the purpose of the study and the age of the child. The best option would be an endofibrogastroscope with a diameter of 6-9 millimeters, in which the optics are located at the ends. It is strictly contraindicated to use devices whose diameter exceeds the age-specific dimensions of the esophagus.

What is VEGDS?

VEGDS (videoesophagogastroduodenoscopy) is the most modern and highly informative option for endoscopy for diagnosing gastrointestinal diseases in children. In addition to obtaining complete and reliable information, it makes it possible to record the procedure on a portable medium.

The study helps determine:

• Presence of foreign bodies
• Pathological changes
• Inflammatory processes
• The structure and structure of the tissues of the esophagus, stomach and duodenum.

FGDS for children: in what cases is it necessary?

Considering the high accuracy and information content of the procedure, FGDS has a fairly wide list of indications both in therapy and in pediatrics. Since fibrogastroduodenoscopy allows you to visually assess the condition of the mucosa and sphincters, and also makes it possible to take material for a biopsy, indications for a planned FGDS for a child may be:

• constant regurgitation syndrome;
• vomiting of unknown etiology;
• diseases of the stomach, duodenum, esophagus, tumor processes;
• developmental defects, anemia;
• differential diagnosis for pain syndrome.

In addition to the listed planned indications for fibrogastroduodenoscopy for children, there are a number of emergency indications: foreign bodies of the digestive tract, cauterization of bleeding vessels, intestinal obstruction and acute gastrointestinal bleeding.

FGSD for children, the cost of which is affordable for most parents, is prescribed for diagnostic or therapeutic purposes.

Preparing children for gastroscopy

Proper preparation for pediatric gastric endoscopy is the key to a successful procedure.

Preparation for gastric endoscopy in children may include additional studies as prescribed by a gastroenterologist and pediatrician.

The stages of preparation are discussed with your attending physician. For your convenience, our specialists provide general recommendations for preparing for pediatric endoscopy:

1. You don't need to follow any special diet. We recommend feeding your child a light dinner the night before, no later than 6 p.m.
2. Typically, gastroscopy is performed for children in the morning, on an empty stomach.
3. We always take care of the emotional background of our little patients! Therefore, we strongly recommend that parents prepare their child through conversations. Explain why the procedure is necessary, what will be done with it and at what point you need to be patient.

Your support is a necessary condition for the baby’s peace and comfort during gastric endoscopy!

1. To distract your child, take his favorite or new toy with you. It will be needed during the procedure.

Stages of pediatric gastric endoscopy: how is gastroscopy performed on children?

Stage 1. Pain relief

In our center, we perform gastroscopy in children under local anesthesia, in the absence of an allergic reaction to lidocaine and novocaine.

Stage 2: Endoscopy of the stomach in a child

1. The patient is placed on a medical couch lying on his left side. The right leg is bent towards the stomach, the left leg is straightened and lies at rest.
2. Children are given a mouthpiece. This device will protect you from injuries to the palate and accidental closing of the mouth.
3. The specialist carefully moves the child’s head back and fixes it in the correct position for the procedure.
4. The endoscopist inserts a pediatric probe (a flexible endoscope of small diameter), and the child makes a swallowing movement, helping the device enter the esophagus.
5. During the procedure we take photographs. All endophotos will be available to you in your personal account on the website. If necessary, we record the study in video format on a portable medium (flash card).

Time for gastroscopy in children: no more than 2-3 minutes.

Anesthesia: individual.

Recovery: not required.

FGDS for a child: contraindications and implementation

Despite the fact that the procedure is safe, there are a number of relative contraindications. FGDS for children is not performed for acute inflammation of the larynx, bronchial asthma in the acute stage, mental instability and the presence of severe general diseases. In each individual case, the decision is made by the doctor. Let us remind you once again that fibrogastroduodenoscopy is the safest study possible and takes place without complications, provided that the procedure is performed by a highly qualified specialist. If you are interested in the question of where to do an FGDS for a child in Kyiv, check out the list of services provided by our doctors: https://www.dobrobut.com/.

Stages of FGDS:

• the child’s oral cavity is treated with an antiseptic and placed on his left side;
• put a mouthpiece in your mouth (to avoid biting the probe);
• the doctor slowly inserts the endoscope;
• The organs being examined are examined (maximum time – 15 minutes).

In some cases, premedication is possible, which is done to avoid discomfort during the examination. This is usually an intramuscular injection of a sedative drug. FGSD is administered to children under one year of age through the nose.

Advantages of pediatric gastroscopy at the Paracelsus Medical Center

• Information content. In our center, we perform video esophagogastroduodenoscopy with the ability to record the study results on an electronic medium (flash drive).
• Experienced specialists. Our doctors provide the most informative results from the procedure and comfort to our little patients.
• Modern technical equipment. Innovative flexible endoscopes minimize discomfort and provide the ability to evaluate the effectiveness of treatment.
• Maximum comfortable conditions. We care about the health of your children! Each of our specialists provides an individual approach to the little patient, taking into account his individual needs.
• Safety. The procedure is completely safe for children.

Grasping pliers with 3 teeth in plastic tube, with loop

The loop-shaped teeth ensure safe extraction and are suitable for removing polyps and foreign bodies.

• Grasping pliers with 4 teeth in plastic tube, with straight hook

Curved edge (straight hook) grippers are ideal for retrieving irregular and soft objects. And the increased number of teeth improves gripping ability.

• Grasping pliers with 4 teeth in plastic tube, with loop

The loop-shaped teeth ensure safe extraction and are suitable for removing polyps and foreign bodies. Increased number of teeth improves gripping ability.

Exciting baskets

Grasping baskets (Dormia baskets) are designed to remove foreign objects from the lower and upper gastrointestinal tract. The different shapes and opening diameters of the Wilson baskets allow the removal of foreign objects of various shapes and sizes.

• Hexagonal retrieval basket

The hexagonal shape of the basket allows you to grasp both large and small objects, as well as objects of complex and long shapes.

• Hexagonal Nitinol extraction basket

The gripping wires are made of nitinol (titanium nickelide), which is characterized by high elasticity, strength, superelasticity (20 times more elastic than steel) and memory of the original shape. The hexagonal shape of the basket allows you to grasp both large and small objects, as well as objects of complex and long shapes.

• Spiral retrieval basket made of Nitinol

The gripping wires are made of nitinol (titanium nickelide), which is characterized by high elasticity, strength, superelasticity (20 times more elastic than steel) and memory of the original shape. The spiral shape of the gripping basket allows you to more reliably grasp the object due to the shape memory properties of nitinol and all-round adherence to the object being removed.

• Oval retrieval basket made of Nitinol

The gripping wires are made of nitinol (titanium nickelide), which is characterized by high elasticity, strength, superelasticity (20 times more elastic than steel) and memory of the original shape. Oval-shaped grasping baskets are often used to grasp stones in narrow passages such as the bile ducts.

Needle electrodes

Wilson's disposable needle electrodes are designed for immediate and rapid electrocoagulation during endoscopic dissection, as well as for the treatment of gastrointestinal bleeding using electrocoagulation.

injection needles

Injection needles are used to administer various medications into the mucous membrane. Endoscopic injectors are suitable for injections during mucosal resection and for sclerotherapy for dilation of esophageal veins.

• Injection needles in a plastic tube

The Teflon coating of the tube ensures safe needle insertion and prevents scratches on the inner surface of the endoscope.

• Injection needles in a metal tube

The distal part of the metal tube is more flexible than that of the Teflon tube.

Polypectomy loops

Polypectomy snares are designed for use with flexible endoscopes and high-frequency surgery devices to capture polyps and excise tissue in the stomach and intestinal cavities using high-frequency current. The loop polypectomy method has recently become the most popular method for removing polyps.

• Polypectomy loop oval, polyline

The thick twisted thread provides better mucosal grip and better coagulation, and also minimizes the slippage of the loop when closing. The oval shape of the loop is the most universal and common, which allows them to be used in most standard clinical cases.

• Polypectomy loop, oval, monofilament

Thin single wire provides a fast and clean cut. Monofilament has a lower coagulation effect compared to polyfilament. The oval shape of the loop is the most universal and common, which allows them to be used in most standard clinical cases.

• Polypectomy loop oval, polyline, rotating

The thick twisted thread provides better mucosal grip and better coagulation, and also minimizes the slippage of the loop when closing. The rotation function makes it easier to position the loop when approaching the polyp is difficult.

• Polypectomy loop, oval, monofilament, rotating

Thin single wire provides a fast and clean cut. Monofilament has a lower coagulation effect compared to polyfilament. The rotation function makes it easier to position the loop when approaching the polyp is difficult.

• Polypectomy loop, hexagonal, polyline

The thick twisted thread provides better mucosal grip and better coagulation, and also minimizes the slippage of the loop when closing. These loops are ideal for removing flat and sessile polyps.

• Polypectomy loop, hexagonal, monofilament

Single hexagonal wire provides a fast and clean cut. Such loops are well suited for the removal of flat and sessile polyps using the cold polypectomy method.

• Polypectomy loop, sickle-shaped, polyline

Crescent loops are used in cases where it is impossible to capture the polyp using an oval loop. Ideal for resection of polyp behind the folds of the colon.

Spray catheters

Spray catheters are used for cleaning the surgical field, washing tissues, and also for spraying various dyes during chromoscopy.

• Spray catheter, jet

Provides direct injection. Used to clean the surgical field. Designed for endoscopes without a dedicated irrigation channel.

• Spray catheter, nebulization

The spray catheter ensures uniform spraying. Used for chromoscopy to spray various dyes (indigo carmine, Lugol's solution, methylene blue, acetic acid, etc.)

• Spray catheter, reverse jet

Provides a jet injection directed in the opposite direction from the endoscope. For reverse spraying. Used for routine cleaning.

Cytological brushes

Cytological brushes are designed for collecting cell samples from the mucous membrane of the upper and lower gastrointestinal tract for subsequent study of their cellular composition. Cytology, along with histology, is one of the main modern methods for determining precancerous conditions.

Cleaning brushes

Wilson cleaning brushes are designed for high-quality mechanical cleaning of endoscope channels, endoscope inlet and adjustment ports (irrigation, water/air, water jet, etc.), as well as for cleaning difficult endoscope surfaces. Manual and mechanical cleaning is an important step in the cleaning and disinfection of endoscopic equipment, medical failure. personnel from cleaning ducts with brushes may result in ineffectiveness of higher levels of disinfection.

• Single-sided cleaning brush, without end bristles

The Teflon coating of the tube minimizes friction with the endoscope channel and extends the service life of the equipment. The dense arrangement of bristles promotes high-quality and quick cleaning. The brushes have a one-sided modification, i.e. The cleaning zone is located on one side of the tool.

• Cleaning brush, single-sided, with end bristles

Single-sided cleaning brushes with end bristles have additional bristles at the end of the tube, due to which they have better cleaning ability and more effectively remove contaminants in the endoscope channel.

• Single-sided cleaning brush with ball

Single-sided cleaning brushes with a ball, due to the presence of a ball-shaped tip, ensure smooth passage of the cleaning tool through the channel without the risk of damage.

• Cleaning brush, double-sided, without end bristles

The dense arrangement of bristles promotes high-quality and quick cleaning. The brushes have a double-sided modification, i.e. The cleaning zone is located on both sides of the instrument, allowing the instrument to be completely pulled through the endoscope channel, providing double cleaning.

• Cleaning brush, double-sided, with end bristles

Double-sided cleaning brushes with end bristles have additional bristles at the end of the tube, due to which they have better cleaning ability and more effectively remove contaminants in the endoscope channel.

• Double-sided cleaning brush with ball

Double-sided cleaning brushes with a ball, due to the presence of a ball-shaped tip, ensure smooth passage of the cleaning instrument through the canal without the risk of damage. Meets the range and requirements of any manufacturers of endoscopic equipment in all directions of flexible endoscopy.

• End-hairless port cleaning brush

A short port cleaning brush with thick bristles and a wide cleaning area is used to clean both valve ports and the irrigation and water/air valves themselves.

• End-pile port cleaning brush

A short port cleaning brush with thick bristles and a wide cleaning area is used to clean both valve ports and the irrigation and water/air valves themselves. The ergonomic handle maintains control over the cleaning procedure. End-bristled brushes can also be used to clean the distal portion of endoscopes and endotherapy instruments in areas of complex mechanical connections.

Electrodes for coagulation

Round-type coagulation electrodes are used for endoscopic electrocoagulation at the site of bleeding using high-frequency current in the gastrointestinal tract.

Reusable tools

Biopsy forceps

Biopsy during gastroscopy is the most common method for identifying various pathologies of the gastrointestinal tract. The material taken using biopsy forceps (which can be taken from any part of the stomach) is sent for histological examination, thereby identifying the nature and stage of development of pathological neoplasms.

• Biopsy forceps for gastroscopes with a working channel of 2.8 mm

• Biopsy forceps for gastroscopes with a working channel of 2.0 mm

Biopsy forceps for hot biopsy

Hot biopsy forceps are used both to take a tissue sample for histological examination and to remove small tumors (for example, polyps), as well as additional coagulation (“cauterization”) of the removal area. The forceps grab the tissue, burn it along the surface, but inside there remains untouched tissue, which is sent for examination.

Foreign body removal grips

Serrated grippers are used to remove various foreign bodies and hard-to-remove food boluss from the gastrointestinal tract. The curved teeth provide exceptional gripping ability and are ideal for removing soft objects.

• Grasping pliers with 3 teeth in metal tube

The 3-prong curved grasping forceps are ideal for grasping soft tissues and objects, have an ergonomic handle and a metal tube made of corrosion-resistant steel for autoclavable sterilization.

• Grasping pliers with 3 teeth in plastic tube

Reusable grippers with 3 atraumatic teeth in a loop design help you safely remove soft and loose tissue and objects. The plastic tube reduces friction in the working channel of the endoscope and avoids scratches.

Exciting baskets

Grasping baskets (Dormia baskets) are designed to remove foreign objects from the lower and upper gastrointestinal tract. The different shapes and opening diameters of the Wilson baskets allow the removal of foreign objects of various shapes and sizes.

• Hexagonal retrieval basket

Convenient for retrieving round and slippery objects. The hexagonal shape of the basket allows you to grasp both large and small objects, as well as objects of complex and long shapes.

• Hexagonal Nitinol extraction basket

The gripping wires are made of nitinol (titanium nickelide), which is characterized by high elasticity, strength, superelasticity (20 times more elastic than steel) and memory of the original shape. The hexagonal shape of the basket allows you to grasp both large and small objects, as well as objects of complex and long shapes.

• Spiral retrieval basket made of Nitinol

The gripping wires are made of nitinol (titanium nickelide), which is characterized by high elasticity, strength, superelasticity (20 times more elastic than steel) and memory of the original shape. The spiral shape of the gripping basket allows you to more reliably grasp the object due to the shape memory properties of nitinol and all-round adherence to the object being removed.

• Oval retrieval basket made of Nitinol

The gripping wires are made of nitinol (titanium nickelide), which is characterized by high elasticity, strength, superelasticity (20 times more elastic than steel) and memory of the original shape. Oval-shaped grasping baskets are often used to grasp stones in narrow passages such as the bile ducts.

Grasping tongs

Grasping forceps, along with grippers and baskets, are used to remove foreign objects from the human body. Thanks to a wide selection of jaw types, you can use gripping forceps to remove almost any foreign body: flat, sharp, large.

• Grasping pliers, alligator type

This type of gripping pliers has elongated serrated jaws, making it easy to grasp sharp and cutting objects.

• Grasping pliers, rat tooth type

Rat-tooth gripping pliers, thanks to their jaw design, easily grasp and remove hard and flat objects.

• Grasping pliers, Alligator-Rat Tooth type

Thanks to the combination of “alligator” and “rat tooth” jaws, these pliers easily grasp and remove hard and flat objects located in hard-to-reach places.

• Grasping pliers, Pelican type

The Pelican jaw design and 10mm jaw opening make it easy to grasp and remove large objects.

• Grasping pliers with rubberized jaws

Thanks to its design, the tongs can easily grasp soft objects.

Needle electrodes

Wilson's reusable needle electrodes are designed for immediate and rapid electrocoagulation during endoscopic dissection, as well as for the treatment of gastrointestinal bleeding using electrocoagulation.

injection needles

Injection needles are used to administer various medications into the mucous membrane. Endoscopic injectors are suitable for injections during mucosal resection and for sclerotherapy for dilation of esophageal veins. The reusable needle is supplied with 1 reusable autoclavable tube (up to 5 uses) and 5 disposable needles.

• Injection needles in a metal tube

Polypectomy loops

Polypectomy snares are designed for use with flexible endoscopes and high-frequency surgery devices to capture polyps and excise tissue in the stomach and intestinal cavities using high-frequency current. The loop polypectomy method has recently become the most popular method for removing polyps.

• Polypectomy loop oval

The oval shape of the loop is the most universal and common, which allows them to be used in most standard clinical cases. The thick twisted thread provides better mucosal grip and better coagulation, and also minimizes the slippage of the loop when closing.

• Hexagonal polypectomy loop

These loops are ideal for removing flat and sessile polyps. The thick twisted thread provides better mucosal grip and better coagulation, and also minimizes the slippage of the loop when closing.

• Crescent polypectomy loop

Crescent loops are used in cases where it is impossible to capture the polyp using an oval loop. Ideal for resection of polyps behind the folds of the colon. The thick twisted thread provides better mucosal grip and better coagulation, and also minimizes the slippage of the loop when closing.

Spray catheters

Spray catheters are used for cleaning the surgical field, washing tissues, and also for spraying various dyes during chromoscopy.

• Spray catheter, jet

Provides direct injection. Used to clean the surgical field. Designed for endoscopes without a dedicated irrigation channel.

• Spray catheter, nebulization

The spray catheter ensures uniform spraying. Used for chromoscopy to spray various dyes (indigo carmine, Lugol's solution, methylene blue, acetic acid, etc.)

• Spray catheter, reverse jet

Provides a jet injection directed in the opposite direction from the endoscope. For reverse spraying. Used for routine cleaning.

Cleaning brushes

Wilson's reusable canal cleaning brushes are designed to clean the instrument canals of gastroscopes with a working bore diameter of 2.0 to 3.2 mm. Manual and mechanical cleaning is an important step in the cleaning and disinfection of endoscopic equipment, medical failure. personnel from cleaning ducts with brushes may result in ineffectiveness of higher levels of disinfection.

• Channel cleaning brush, single-sided, without end bristles

Electrodes for coagulation

Round-type coagulation electrodes are used for endoscopic electrocoagulation at the site of bleeding using high-frequency current in the gastrointestinal tract.

Question answer

1. Is it possible to have a gastroscopy performed on a child in Istra? Yes, you can have an endoscopy performed on a child from 6 years old at the Paracelsus Medical Center.
2. Is it possible to do an endoscopy without a doctor's prescription? No. The decision on the advisability of performing VEGDS is made by your attending physician. Pediatric endoscopy is performed only as prescribed by a pediatrician or gastroenterologist.
3. At what age can a child have a gastroscopy? The advisability of performing VEGDS or video esophagogastroduodenoscopy and an assessment of the risk-benefit ratio is determined only by a gastroenterologist during the admission process. Gastroscopy is a relatively safe procedure that can be performed even on newborn children, that is, from the first days of life.
4. When can you eat after gastroscopy? The last meal should be light and no later than 18 pm.
5. Is it possible to drink water before gastroscopy? We do not recommend drinking any liquids before the procedure. The fact is that during the procedure the natural gag reflex increases, which can complicate gastroscopy. It is allowed to wet the mouth with water without swallowing the liquid.

Disposable instruments for gastroscopy

Disposable instruments help avoid cross-infection between patients during gastroscopy. In addition, there is no need to purchase expensive sterilization equipment. The disposable instrument is sterilely packaged and is always ready for use.

Biopsy forceps

Biopsy during gastroscopy is the most common method for identifying various pathologies of the gastrointestinal tract. The material taken using biopsy forceps (which can be taken from any part of the stomach) is sent for histological examination, thereby identifying the nature and stage of development of pathological neoplasms.

• Biopsy forceps for gastroscopes with a working channel of 2.8 mm

• Biopsy forceps for gastroscopes with a working channel of 2.0 mm

Biopsy forceps for hot biopsy

Hot biopsy forceps are used both to take a tissue sample for histological examination and to remove small tumors (for example, polyps), as well as additional coagulation (“cauterization”) of the removal area. The forceps grab the tissue, burn it along the surface, but inside there remains untouched tissue, which is sent for examination.

• Biopsy forceps for hot biopsy for gastroscope with working channel 2.8 mm

Mouthpieces

Biting and damage to the endoscope during gastroscopy is a fairly common occurrence, which leads to damage to expensive equipment. To prevent this problem, mouthpieces are used. For convenience and fixation of the mouthpiece on the patient's head, a rubber band is used. Wilson mouthpieces are universal and fit all endoscopes from well-known manufacturers.

• Mouthpiece without retainer and elastic band

A standard mouthpiece is fixed using the patient's teeth and does not have additional fastenings for a rubber band. You can choose a sterile or non-sterile option.

• Mouthpiece with retainer and elastic band

The rubber band, covering the patient's head, is securely fastened and ensures a stable position of the mouthpiece during the entire procedure. You can choose a sterile or non-sterile option.

• Mouthpiece with fastener without elastic band

A mouthpiece with a lock to which a rubber band is attached. Supplied without rubber band. You can choose a sterile or non-sterile option.

Foreign body removal grips

Serrated grippers are used to remove various foreign bodies and hard-to-remove food boluss from the gastrointestinal tract. The curved teeth provide exceptional gripping ability and are ideal for removing soft objects.

• Grasping pliers with 3 teeth in plastic tube, with straight hook

Curved edge (straight hook) grippers are ideal for retrieving irregular and soft objects.