17. Inspection of the Oropharynx and Upper Gastrointestinal tract.

17. Inspection of the Oropharynx and Upper Gastrointestinal tract.

The Tulip design allows easy access to the laryngeal inlet and the entrance of the oesophagus, as it forms the seal high in the oropharynx. It is possible to thoroughly examine the larynx and upper gastrointestinal tract by using a well lubricated endoscope and passing it through the central breathing tube lumen of the Tulip when in-situ. Small diameter endoscopes may be used with minimal airway obstruction, thus allowing their use through a sealed side-port whilst the Patient maintains either spontaneous or controlled ventilation with a sealed-circuit system throughout the examination.

This may be done effectively using the available side-port endoscopy attachment. The attachment consists of a plastic tube with standard 15mm connectors at both ends and a curved, rubber-ring sealed side arm which allows insertion of the endoscope into the anaesthetic circuit. The connector has upon one side a curved arm with a rubber/plastic sealing ring at its outer end through which the lubricated endoscope may be inserted without a gaseous leak acheter viagra au meilleur prix. The sealing ring hence allows the endoscope to be passed into the anaesthetic circuit without any leakage of oxygen or volatile gases. This consequently greatly reduces the levels of ambient theatre volatile vapor, and allows the Anaesthetist to effortlessly maintain an ideal state of anaesthesia using either a simple spontaneous or controlled ventilating O2/volatile technique which currently is difficult and unpleasant due to high ambient gas and vapor levels. Using this method, the Patient may be managed using either spontaneous or positive pressure ventilation as the Anaesthetist requires.

This side-port endoscopic attachment allows a full examination of the relevant anatomy without interrupting or interfering with the delivery of oxygen or anaesthetic volatiles, hence maximum saturation is possible without fluctuations in the anaesthetic depth that may easily occur using current techniques. This then provides ideal anaesthesia and surgical conditions for examination or surgery.

Recovery from such a procedure entails only a removal of the endoscope and the endoscopic anaesthetic connector, and re-attachment of the anaesthetic circuit. The Patient may then be transferred to the recovery area as soon as the respiratory pattern has been established satisfactorily without any further manipulation of the airway.

With the Tulip remaining in position throughout the entire procedure, the airway is at all times controlled, with manual, controlled or spontaneous ventilation possible right up to the time when the Tulip is removed by the Patient themselves on return of oropharyngeal and laryngeal reflexes.

This Tulip technique, it can be seen, allows ideal conditions for both the Surgeon and Anaesthetist, and removes the variance in anaesthetic depth that can occur with total intravenous anaesthesia (T.I.V.A.), and allows the airway to be secured, sealed and ventilating at all times.