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1/ Any takers on whats this #GITwitter 
Reviewing principles of single
enteroscopy w our #GIFellows
Mini-Tweetorial
I follow “STIR”
S:Scope forward
T:Tube forward until 50 cm on the scope
I:Inflate balloon
R:Reduce
Dont advance tube when is inflated
Reviewing principles of single
enteroscopy w our #GIFellows Mini-Tweetorial
I follow “STIR”
S:Scope forward T:Tube forward until 50 cm on the scope I:Inflate balloon R:Reduce Dont advance tube when is inflated
2/ Some practical tips that I use during enteroscopy
Lubricate tube & balloon before insertion
Flush water through tube channel as well as scope, helps scope slide better through small bowel
I like my simethicone in small bowel
Image by Japanese Enteroscopy Study Grp
Lubricate tube & balloon before insertion Flush water through tube channel as well as scope, helps scope slide better through small bowel I like my simethicone in small bowelImage by Japanese Enteroscopy Study Grp
3/ During the procedure:
I find keeping shaft of scope as straight as possible more helpful (image on right)
Glucagon helps
Once in jejunum, suction & using the dials to manuever turns helps in advancing more than pushing & torque
Have ur assist keep tube straight
I find keeping shaft of scope as straight as possible more helpful (image on right) Glucagon helps Once in jejunum, suction & using the dials to manuever turns helps in advancing more than pushing & torque Have ur assist keep tube straight
4/ Other lessons I learned
Once deep in SB, think of the tube as bite block in EGD
Often have to stand far from pt to keep scope straight
In RNY- often the angulated entry point is biliary limb (been wrong before)
Abd pressure helps
Dont forget shoe covers 
Once deep in SB, think of the tube as bite block in EGD Often have to stand far from pt to keep scope straight In RNY- often the angulated entry point is biliary limb (been wrong before) Abd pressure helps Dont forget shoe covers
5/ Deep enteroscopy can be challenging & feel not rewarding at times
Need lots of patience if you decide to undertake
Devices can be challenging to get through due to looping - I find duraclips to go most easily among TTS clips
The END/
What are your pearls #GITwitter ?
Need lots of patience if you decide to undertake Devices can be challenging to get through due to looping - I find duraclips to go most easily among TTS clipsThe END/
What are your pearls #GITwitter ?
